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PAEDS SC1 > neonates > Flashcards

neonates Flashcards

1
Q

newborn screening

A 
PKU 
Homocystinuria 
MSUD
Congenital toxo 
Congenital hypothyroidism 
GALACTOSAEMIA
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2
Q

caput succedaneum

A

brusing and odeam of the presenting part
Resolves within few days
EXTENDS BEYOND SKULL MARGIN

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3
Q

Caphalhaematoma

A

heamatoma from bleeding bellow the periosteum
invovles parital bone
CONFINED TO SKULL MARGINS

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4
Q

Cignon

A

from vacum deliveries - odeam and brusing of head

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5
Q

what is the risk of getting NEC if you dont breast feed

A

6X

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6
Q

what is the risk of getting Gastroenteritis if you dont breast feed

A

5X

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7
Q

what is the risk of getting Resp distress, otitis media, ecema and wheeze if you dont breast feed

A

2 times increase

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8
Q

number one cause of prematurity

A

spontaneous - 45%
delivery / maternal infection - 30%
PROM - 25%

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9
Q

RDS RF

A

Males , 2nd born and materneral DM

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10
Q

RDS Dx

A

Ground glass apperance and AIR BRONCHOGRAM

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11
Q

TTP Dx

A

fluid in the horizontal fissure

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12
Q

Conenital pneumonia Dx

A

Non specific patchy infiltrates
Neutropenia
Trachal aspiration and
Gram stain for Dx

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13
Q

when does RDS present

A

48-72 hours after birth in resp distress

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14
Q

Treatment RDS

A

CPAP
Artifical surfactant
3. pretreat mom at risk w. corticosteroids

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15
Q

complications of RDS

A

RIPBBN

Retinopathy of prematurity
Intracentricular Heamorrage e

BPD
Barotrauma - from postive pressure ventillation

NEC

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16
Q

apnea of prematurity

A

20sec no breath
normal in preterms
Adnormal if term / worsening / no hx

Cause
- poor resp drive or airway problem or BOTH

STIMULATE
O2 / CAP
CAFFINE

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17
Q

BPD

A

infants with low birth weight and those who receive prolonged mechanical ventilation to treat respiratory distress syndrome (RDS).

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18
Q

Dx BPD on X-ray

A

Streaky intersitial marking
Atelectasis
Cyst
hyperinfilated

Diganosed at age 28 weeks old

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19
Q

NEC CLINICAL EARLY THEN LATE

A 
Early 
- feeding difficulties 
- delayed gastric emptying 
Distension 
- bloody stools

Lateral

  • interestinal perforation
  • peritonitis
  • abdo erythema
  • shock
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20
Q

RF NEC

A

PReterm

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21
Q

Dx

A

pneumoatosis intestinalis - hten take US every 60 minutes to see if it become walled off or bowl necrosis

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22
Q

treatment

A

IV metranidazole and surgery

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23
Q

complication NEC

A

strictures and short bowl syndrome

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24
Q

what age do you get nec

A

w/i days - weeks of birht

BABIES BORN EARLIER GET NEC AT LATER AGES

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25
Q

retinopathy of prematuritis

A

retinal vessels develop at 32 weeks - therefore preterm are at risk

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26
Q

IVH

A

germinal matric and neurons mirgrate during last few weeks of utero

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27
Q

DDX Mekles

A

technitium 999 pertechnetate

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28
Q

Treatment of intussuception

A

Air contrast barium edema

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29
Q

cause of constipation in newborn

A 
HHHA 
Hypothyroidism 
HYPERcalemia 
Hirshprund 
Anal stenosis
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30
Q

Sepsis clinical and treatment

A

EARLY 4 days

  • fuminating multisystem pneumonia
  • 15-50%
  • Benzylpenicillin and gentamycin

Lat >4
- focal progressive meningitis
- 10-20%
Treat w/ fluoxacillin and gentamycin

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31
Q

chlamydia vs. gonorrhea infection in baby

A

Chlamydia - 5-14 days

Gonorrhea 2-5 days

32
Q

5 things cafe au lait spots are ass. w.

A 
NF1 
MArphans 
Tuberous sclerosis 
McCune Albright 
Fanconi anemia
33
Q

kassabach Meritt syndrome

A

Telangetasia and haemaginoma

34
Q

Klippel Trenaunay Syndrome

A

Capillary malofrmation and overgorwth

bone and limb defect

35
Q

who get umbilicated hernia

A

Downs
Hypothyrpidism
PRETERM

REFER FOR TREATMENT IF it does not resolve by age 3

36
Q

Sandifers syndrome

A

GERD ass. w/ lateral head til and back arching resulting in osephagitis

37
Q

cause of GERD

A
  1. Decrease LES
  2. inappropiate LES relaxation
  3. Large histus hernia
  4. dealyed gastric emptying
38
Q

treatment of GERD

A

Sit up right
Thicker formulas
H2 antagonist - CIMETIDINE - to help reduce the reflux

Resolves w/i 9-18 months and if it does

NISSEN FUNDOPLICATION

39
Q

SE of phototheraphy

A 
interupt maternal bonding 
Dehydrating 
Hyperthermia 
rentinal deamge 
Decrease intestinal transiet
40
Q

Se of exchange transfusion

A 
death 
infection 
thrombocytopenia 
port vein thrombosis 
NEX 
Electrolyte imblance 
Gvs, Host
41
Q

when to do exhcnage transfusion vs. phototherphy

A

UCB >20

42
Q

physiological jaudice of a newborn why?

A
  1. pathway of bilirbunin excretion is not mature
  2. extrahepatic circulation
  3. 70-90 days in term
  4. 40 days in preterm

INCREASE HCT than adults
CEPHALOHEAMATOA

43
Q

kernicturis

A

complication of UCB > 25 when it deposits in the basal ganglion pons and cerebellu

>25- 30 mg/dl 
Risk factor ;
- PRETERm 
- Aphyxia
- Sepsis

PENTAD
- MOTOR - OCULOMOTOR _ CHOcLEAR - ID

44
Q

causes of polycythemia

A 
Vennous hct is ?65% or more 
Increase hct = increase viscosity 
Causes 
chronic IUGR 
Excessive transfusion (delayed cord clamping 
infant of diabetic mom 
CLinical 
BRAIN - jitteriness, headache 
HEART - HTN , PFC 
REnal 
GI - NEX 
HYpoglycemia and Jaudice
45
Q

when does heamolytic disease of newborn present

A

2-4 days

46
Q

causes of RAISED alpha fetal protein

A

NOT CO TPN
Normal
Omphalocele
Twins

Congenital nephorisis
Oligohydramniosis

Turners
Pateau
NTD

47
Q

Clinical hydrocephalus

A 
The syptoms of INCREASE Intacranial pressure 
vomitting and decrease LOC
anterior fontanelle open and buldging 
scalp weins are dilated 
space suture 
EYES DEVIATED DOWN ( SUN SETTING)
48
Q

treatment of hydrocephalus

A

Acetazolamide plus/minus furosemide
Serial lumbar puncture
VP shunt

49
Q

Dx hydrocehalus

A

antenatal US
cranial US
CT or MRI
head circumferance

50
Q

treatment of cleft lip

A

refer to specialist unit
3 moths - lip repair
Palate repair at 9-12 months

51
Q

Wide forehead with a small triangle-shaped face and small, narrow chin

A

Russell-Silver syndrome

52
Q

high arch palate , micrognathia and prominant tongue

A

Pierre Robin Syndrome

0 feeding problem and airway obstruction

53
Q

MEC aspiration Complication

A

Mechanical obstruction
Chemical pneumonitis
obstruction
pneumothorax

54
Q

overinflated lung with patches of consolidation and collapse

A

Meconium Aspiration

55
Q

treatment of penumonia in neonates

A

benzylpenicillin and gentamycin

56
Q

pneumothorax caues

A

secondary to

  • MEc aspiration
  • RDS
  • mechanical respiration
57
Q

Pneumothorax treatment

A

small - O2 and 2ICS aspirate

Larger - 5ICS chest drainage

58
Q

PPHT of Newborn causes

A

birth aphyxia
MEC
SEPticaemia
Resp Distress

59
Q

treatment of PPHN

A

Mechanical ventilation and cirulatory report
inhaled NO - causes pulm arteries to vasodilate and therefore reduce pressures
high frequence oscillatory ventilation (HPOV) and ECMO

60
Q

what can BPD result in

A

Cor pulmonale

61
Q

venous hum

A 
benign murmur 
age  >2 
infraclavicular area 
louder on right 
Muscial hum 
ASCENTUATED with diastolic inspiration

Resloves the murmus
- placing child supine
- turning child’s neck and
Compressing jugular vein

62
Q

Stil murmur

A

AGE 3-5
vibratory low frequency
increased in HIGH states
Positional change

63
Q

symptoms of Systolic murmur

A 
Systolic 
Short 
Soft/ low pitch 
Left Sternal edge 
Positional changes
64
Q

hypoxia (nitrogen washout test

A

R - L shunt
determines presence of disae
100% O2 for 10 minutes
if right radial aterial

65
Q

complications of dibaetes in pregnancy

A
  1. Calvical fracture
  2. RDS
  3. Hypoglycemia
    • give early feeds or IV glucose if they cant feed
  4. Congenital
    • anencepahly, holoprosencaphaly, meningomylocele, sacral agenesis
    • small left colon syndrome
    • CHF (TGV , HOCM)
  5. Polycythemia
  6. Renal vein thrombosis
  7. Jaucine - hyperbilinrunemia
  8. Hypocalemia - hyper phosphate/ hypo Mg
  9. IU fetal dealth
  10. TTP
66
Q

how is congenital diapharamic hernia normally dx

A

anternatal US
Right - more difficult to dx b/c liver and collapse lung have similar apperance
Left - fluid filled stomach

OR BY POLYHYDRAMNIOS

67
Q

ddx CDH

A

CAM - cyst adenmatoid malformation pulm sequestration
neurenteric and dublicated cyst
Cystic teratoma

68
Q

Post natal presentation CDH

A

first few hours - resp distress - if they have pulm hypoplasia
Pulmonary HTN

69
Q

intermediate or early presentation CDH

A

minutes or few hours of birth with
0 resp distress, tachypnea , cyanosis, sternal recession and marked hypotonia
SCAPHOID ABDOMEN

70
Q

Cxray of CDH

A

fluid dilled loops in chest
nasogastric tube
Lack of intestinal gas shawdoe

If normal you think CAM

71
Q

late presentation of CDH

A

LESS DRAMATIC w/ better prognosis
alveolar development
less pulm HTN
FLuid filled loops in chest

Clinical - vomitting and requesnt chest infection

72
Q

treatmnet of CDH

A
  1. IV access
  2. O2
  3. Urinary catherter
  4. fluids and pressor
  5. restricted fluids
73
Q

good prognosis for CDH / normal prognosis

A
  1. present later 2 years of life
  2. stomach is NOT in chest
  3. less pulm HTN
  4. Better prognosis

Normal prognosis - 50% mortality

74
Q

CDH is ass. w/

A 
PENTAD CANTRELL 
sternal 
exophalus 
Pericardia 
Coarctation 
Pericardia
Ventircular Arterial septal defect
75
Q

treatment of meconium ileus

A

corrected by doing hydrophilic contrast enema (Gastrograffin) –> softens and inspissated meconium to faciliate package
NOTE: IVE ACCESS FLUID CAUSE GASTROGASTRIN CAN CUASE DEHYDRATION
Reactal distal ileum -

76
Q

Ladd’s band

A

malrotation

77
Q

treatment of fastroschis

A

CLING FILM WRAP
NGT - antibiotics
IV FLUIDS 10-20mls/kg
Colon washout with gastrograffin

If successful closeure - TPN 2-3 weeks

PAEDS SC1 (13 decks)

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