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MRCPCH FOP/TAS > Neonates > Flashcards

Neonates Flashcards

1
Q

Is neonatal jaundice more common in breast or bottle-fed babies?

A

Breast-fed

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2
Q

What is meant by pathological neonatal jaundice?

A

< 24 hrs after birth

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3
Q

What is meant by prolonged neonatal jaundice?

A

> 2 weeks in term baby or > 3 weeks in pre-term

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4
Q

Give causes of pathological jaundice.

A

Sepsis
Rhesus / ABO haemolytic disease
Hereditary spherocytosis
G6PD deficiency

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5
Q

Why does physiological jaundice occur?

A

Due to a number of factors including immature liver function and fragile RBCs

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6
Q

Give causes of prolonged neonatal jaundice.

A

Biliary atresia
Hypothyroidism
UTI
Breast milk jaundice
Galactosaemia
Prematurity
Congenital infections

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7
Q

What is the normal volume of amniotic fluid for a term birth?

A

~600mls

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8
Q

What is meant by neonatal hypoglycaemia?

A

BM < 2.6 in first 24h of life or < 3 thereafter

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9
Q

Give some risk factors for neonatal hypoglycaemia.

A

Diabetic mothers
Small/large for dates
Preterm

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10
Q

Give some causes of neonatal hypoglycaemia.

A

Hyperinsulinism
Endocrine disorders
Metabolic conditions
Sepsis

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11
Q

What is the immediate treatment for mild neonatal hypo?

A

Breast feed

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12
Q

What is the most common cause of persistent neonatal hypoglycaemia?

A

congenital hyperinsulinism

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13
Q

Which drug taken in late pregnancy may increase the risk of kernicterus?

A

Sulphonamides

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14
Q

What are the components of newborn screening in the UK?

A

Physical Exam
Newborn bloodspot
Newborn hearing screening

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15
Q

Which conditions does the newborn bloodspot screen for?

A

Cystic fibrosis, congenital hypothyroidism, sickle cell disease, MCADD, PKU, MSUD, IVA, GA1, homocystinuria

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16
Q

What is the first-line test used in newborn hearing screening?

A

Automated otoacoustic emission test

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17
Q

If a baby does not pass the first newborn hearing screening test, which test is used?

A

Automated auditory brainstem response

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18
Q

What is the largest component of surfactant?

A

Phosphatidylcholine

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19
Q

What is the main risk factor for neonatal sepsis?

A

Prematurity

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20
Q

What is the most common cause of early-onset neonatal sepsis?

A

GBS

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21
Q

Give common causes of late-onset neonatal sepsis.

A

Staph epi, Klebsiella, Pseudomonas, Enterobacter

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22
Q

What investigations would typically be done in a neonatal sepsis screen?

A

Bloods & gas
Blood & urine cultures
LP

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23
Q

What is the empiric antibiotic treatment for neonatal sepsis?

A

IV benpen and gentamicin

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24
Q

What are the key risk factors for NEC?

A

Prematurity/ low birth weight
Formula-fed
Sepsis
CHD
Ventilated

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25
Q

What are the key features of NEC on AXR?

A

Dilated/thickened bowel loops
Pneumatosis (gas in bowel wall)
Pneumoperitoneum
Gas in portal veins

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26
Q

What is the immediate management for NEC?

A

Refer to Paeds Surgeons
Make NBM, IVF, TPN, insert NGT and treat with antibiotics

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27
Q

Parietal bone swelling, does not cross suture lines suggests…

A

Cephalohaematoma

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28
Q

Boggy swelling crossing suture lines suggests…

A

Caput seccundum

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29
Q

What is the target growth velocity for a baby receiving adequate nutrition?

A

15g/kg/day

30
Q

Lung hypoplasia and poor cartilage development suggests…

A

Jeune Syndrome

31
Q

What are common causes of neonatal rash?

A

Erythema neonatorum toxicum
Acne neonatorum
Milia
Miliaria

32
Q

How long does neonatorum toxicum typically take to resolve?

A

5 - 14 days

33
Q

Dermal melanosis / Mongolian blue spot tends to resolve by what age?

A

6 years

34
Q

What is the natural history of a port wine stain / naevus flammeus?

A

Tend to get thicker and darker over time

35
Q

What is the recommended treatment for port wine stain?

A

Early laser therapy

36
Q

Pink/red birthmark darker on child crying suggests…

A

Naevus simplex / salmon patch

37
Q

What is the natural history of salmon patches?

A

95% regress by age 2

38
Q

If treatment is indicated for an infantile haemangioma, what medical treatment may be considered?

A

Beta blockers

39
Q

What is meant by ‘early’ neonatal hypoglycaemia?

A

< 48h of age

40
Q

Give causes of early neonatal hypoglycaemia.

A

HIE, diabetic mother, small babies

41
Q

Capillary haemangiomas are formed from…

A

Proliferating endothelial cells

42
Q

What is the main protein in breast milk?

A

Whey

43
Q

Boiling milk can lead to…

A

Thiamine deficiency

44
Q

Which study supports neonatal saturations 91-95%

A

BOOST IIH

45
Q

How should HR be measured in a neonate?

A

Stethoscope

46
Q

Which antenatal problem is associated with renal agenesis?

A

Oligohydramnios

47
Q

What is the standard treatment for persistent pulmonary HTN of the newborn/>

A

Inhaled NO

48
Q

Neonate with vesicular rash, coagulopathy and hepatomegaly suggests…

A

Disseminated herpes simplex infection

49
Q

When does surfactant production begin in-utero?

A

~ 24 weeks

50
Q

Which hormone contributes to RDS in babies of diabetic mothers?

A

IGF-1

51
Q

Which babies need screening for retinopathy of prematurity?

A

Born before 31 weeks or birth weight < 1.5kg

52
Q

For babies born before 31 weeks, when should screening for ROP take place?

A

Within week 31 or at 4 weeks post-natal age (whichever is later)

53
Q

Scaphoid abdomen suggests…

A

Congenital diaphragmatic hernia

54
Q

Failure of which structure to regress causes Meckel’s diverticulum?

A

Vitelline duct

55
Q

Duodenal atresia occurs due to…

A

Recanalisation error

56
Q

Cyanotic baby, pink when crying suggests…

A

Choanal atresia

57
Q

Which breastmilk component aids with iron metabolism?

A

Lactoferrin

58
Q

Which breastmilk component helps to regulate metabolism?

A

Leptin

59
Q

Maternal active herpes disease at which point in pregnancy is potentially most detrimental to the foetus?

A

1st trimester

60
Q

Anhydramnios with resp distress suggests…

A

Pulmonary hypoplasia

61
Q

What are the 5 stages of embryonic lung development?

A

Embryonic > Pseudoglandular > Canalicular > Saccular > Alveolar

62
Q

Where are pre-ductal sats measured?

A

Right hand

63
Q

Where are post-ductal sats measured?

A

Foot

64
Q

What are normal values for pre and post ductal sats?

A

Both > 95%, differential of <3 %

65
Q

A pre and post ductal sats differential suggests…

A

Mixing of arterial and venous blood through duct

66
Q

How should infants with CDH be managed at birth?

A

Intubation and ventilation

67
Q

What is the most prevalent condition tested for on the Guthrie card?

A

Congenital hypothyroidism

68
Q

At what gestational age does the skin mature?

A

34 weeks

69
Q

What is the main cause of ROP?

A

Hyperoxaemia

70
Q

Which antibiotic should be added if early-onset neonatal sepsis is found to be gram negative?

A

Cefotaxime

MRCPCH FOP/TAS (11 decks)

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