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Neonates > neonates > Flashcards

neonates Flashcards

1
Q

Inhaled nitric oxide reduces the need for ECMO by how much?

A

40%

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2
Q

what is suggestive of PPHN

A

pre and post ductal difference >20%

pre-ductal sats <90%

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3
Q

Nitric oxide has a short half life because??

A

bind to Hb

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4
Q

HFOV is indicated in which circumstances

A

rescue for failed conventional ventilation
improved gas exchange in air leak syndromes
decrease ventilator related injury

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5
Q

What are the pitfalls of Newborn screening

A

1) doesn’t pick up high TSH (hyperthyroidism and panhypopit)
2) In CF doesn’t test all genes - will miss 5%
3) doesn’t test all metabolic disease will miss lysosomal storage disorders

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6
Q

what are the target saturation at what minutes after birth in neonatal resus?

A 
1 min 60-70%
2min 65-85%
3min 70-90%
4min 75 -90%
5min 80-90%
10min 85-90%
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7
Q

what is the dose of adrenaline in neonatal resus IV and ETT?

A

IV 0.1-0.3mL/kg 1:10,000

ETT 0.5-1mL/kg 1:10,000

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8
Q

what is the ratio of compressions to breaths in neonatal resus?

A

3:1

90 compressions to 30 breaths per min

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9
Q

how can you measure UAC and UVC position

A

UAC = (weight x 3) +9
ideal position T6-9

UVC = (weight x 1.5) + 5.5
ideal T9-10, junction ductus venous & IVC

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10
Q

what is the definition of ELBW, VLBW, LBW, SGA

A

ELBW = <10th centile

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11
Q

What is the most important complication of BPD

A

pulmonary hypertension

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12
Q

what is surfactant produced and by which cells?

A

produced 24/40, type 2 alveolar cells

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13
Q

how does steroids increase surfactant production?

A

binding to intra-cytoplasmic receptor and increasing DNA transcription

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14
Q

what is artificial surfactant made of?

A

DPPC + SPB and SPC

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15
Q

what Long term outcome doesn’t surfactant and antenatal steroids influence?

A

development of BPD

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16
Q

what are the pro’s of caffeine

A 
increases central drive
increases contractility diaphragm 
decreases BPD
decreases ROP
Less toxic that aminophylline
17
Q

term baby born by traumatic delivery and develops apnoea at 24hrs of age. ?diagnosis

A

subdural most common

18
Q

indications of HIE and classification

A

mild - hypertonia, dilated pupils, tacchycardic
mod - hypotonia, constricted pupils, seizures
severe - comatose, no reflexes

19
Q

indications for cooling

A

acidosis pH 35/40
within 6hrs of birth

Cool 33.5 degrees 72hrs

20
Q

contraindications to cooling

A

80%
congenital abnormalities
coagulopathy

21
Q

outcomes of HIE

A

mild - nil
mod - 5% mortality, 20% morbidity
severe - 75% mortality, 90+% morbidity

22
Q

what CP is associated with IVH

A

athetoid CP

23
Q

Neuro sequelae for IVH

A

Only grade 3-4

24
Q

Survival stats for pre-terms

A

23/40 25% survival, 90% disability
24/40 65% survival, 75% disability
25/40 85% survival ~50% no disability
28/40 95% survival

25
Q

Premature babies are at risk of osteopenia prematurity because?

A

transplacental passage of Calcium and Phosphate >24/40

26
Q

Vitamin D supplementation is associated with which outcomes?

A

lower pneumonia
lower T2DM
lower rates infleunza
lower asthma exaccerbations

27
Q

Probiotics decrease NEC but they have no impact on?

A

Rates of sepsis

28
Q

how do you calculate mean airway pressure?

A

(Pip x i-time) + (PeeP x e-time) / i-time + e-time

29
Q

what is a normal I;E ratio

A

1:2

30
Q

How can you calculate GIR

A

(dextrose % x IV rate) / (6 x weight)

formula has dextose concentration of 7%

31
Q

what is the biggest risk factor for hospitalisation in RSV

A

chronological age

32
Q

what is the duration of sleep for babies

A

16hrs, mostly REM sleep

33
Q

indications for Palavizumab

A

BPD infants

congenital heart disease with sign left to right shunts especially pulmonary hypertension

34
Q

what are the results for Palavizumab

A

reduced hospitalisation by 50% (10% to 5%)

DOES NOT reduce need for ventilation or mortality

35
Q

what are there TORCH infections and specific differentiating signs for each

A 
Toxo - hydrocephalus 
CMV - periventricular calcification
Rubella - cardiac lesions PDA, PS
Syphilis - rhinitis and desquamation
VZV - Cicatricial skin lesions, hypoplastic limbs
36
Q

treatment congenital CMV

A

valganciclovir 6months = better outcomes

37
Q

Management of bay to Hep B + mother

A

HBIG and HB vaccine within 12 hrs of birth

plus 2,4, 6 months

38
Q

management of baby born to mother with chickenpox

A

give ZIG 7 days prior and 2 days post

if preterm give 2-28 days post birth

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