Neonates Flashcards

1
Q

What is the compression to ventilation ratio for newborn resuscitation?

A

3:1

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2
Q

How long should cord clamping be delayed for following complete delivery?

A

Cord clamping should be delayed for at least 1 minute

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3
Q

Should you attempt to aspirate meconium from the nose and mouth of an unborn infant while the head is still on the perineum?

A

NO

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4
Q

What are the 3 fetal ducts which should close/ constrict in the perinatal period?

A

Ductus venosus

Foramen ovale

Ductus arteriosus

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5
Q

What happens to circulating prostaglandin levels after birth?

A

Circulating prostaglandins drop

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6
Q

What does the ductus arteriosus become?

A

The ligamentum arteriosus

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7
Q

What does the ductus venosus become?

A

The ligamentum teres

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8
Q

Why does persistent pulmonary hypertension of the newborn occur?

A

The ductus arteriosus remains open, causing shunting of blood from the RV to the descending aorta, causing hypertension

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9
Q

What are the management options for persistent pulmonary hypertension?

A

Ventilation and oxygen

Nitric oxide

Sedation

Inotropes

ECLS

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10
Q

What factors make newborns susceptible to heat loss and hypothermia in the first few hours of life?

A

Wet when born

Large surface area

No shivering

Main source of heat production is the breakdown of brown fat (this is not efficient in the first 12 hours of life)

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11
Q

Why are small for dates/ preterm babies most susceptible to hypothermia?

A

They have lower stores of brown fat, little subcutaneous fat and a large surface area

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12
Q

Describe the changes in glucose homeostasis in newborns

A

Drop in insulin, increase in glycogen

Mobilisation of hepatic glycogen stores for gluconeogenesis

Ability to use ketones as brain fuel

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13
Q

Why does physiological anaemia occur in newborns?

A

Adult Hb is synthesised more slowly than fatal Hb is broken down

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14
Q

Why does physiological jaundice occur?

A

Liver enzyme pathways are present but immature

Breakdown of fetal Hb causes a rise in unconjugated bilirubin

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15
Q

What is considered a normal weight for a neonate?

A

2.5kg to 4kg

Large for gestational age >4kg
Small for gestational age <2.5kg

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16
Q

When is considered term?

A

37- 41 weeks

17
Q

What is the apgar score used for?

A

The apgar score is a measure of perinatal adpation scored out of 10

Normal is >8

18
Q

What does APGAR stand for?

A

Alertness, pulse, grimace (reflexes), activity (muscle tone), respiration

19
Q

What respiratory bacterial infection are neonates at risk of?

A

Group B streptococcus infection

20
Q

What is hydrops fetalis?

A

Widespread oedema

21
Q

What is potter’s syndrome?

A

Kidney failure causes oligohydramnios (lack of amniotic fluid) which causes abnormal features in the newborn

22
Q

How does respiratory distress syndrome present?

A
Tachypnoea
grunting 
nasal flaring 
intercostal recessions 
cyanosis
23
Q

What is the underlying pathology behind RDS?

A

Surfactant deficiency and structural abnormalities

24
Q

When does retinopathy usually present in newborns?

A

6-8 weeks following delivery

25
Q

When does necrotising enterocolitis present?

A

After the baby has had its first milk as there is then substrate in the bowel - this will be within the first couple of weeks of life

26
Q

How does necrotising enterocolitis present?

A

Causes an infection in the bowel wall which can involve necrosis and abscess formation

Feeding intolerance, abdominal distension, blood stools

May be fatal or result in small gut syndrome

27
Q

What is meconium ileus?

A

Blockage to the passage of meconium through the bowel due to poor quality of the meconium

28
Q

When and how does meconium ileus present?

A

Presents in the first 24-48 hours

Abdominal distension and vomiting

29
Q

What would be the x-ray appearance in a newborn with meconium ileus?

A

Colon appears narrow and thin - meconium has not been passed and therefore the bowel has never been used before

30
Q

What is jejunal atresia?

A

Obstruction in the wall of the bowel

31
Q

When and how does jejunal atresia present?

A

Occurs within 24 hours of birth

Distended abdomen
Initially keen to feed but keeps vomiting

32
Q

When and how does malrotation present?

A

Occurs 3-7 days after birth

Peritoneal signs
Haemodynamic instability
GREEN VOMIT

33
Q

How does an inguinal hernia present?

A

More common in males

Bulge lateral to the pubic tubercle

34
Q

What does pneumo peritoneum mean?

A

Free air in the abdomen

35
Q

What treatment should neonates born to epileptic mothers be given?

A

IM vitamin K 1mg

36
Q

Describe how/ why the foramen oval closes after birth

A

Immediately after the birth the umbilical arteries spasm in response to the difference in temperature between the outside world and the uterine environment. This greatly reduces venous return to the heart. Pressure in the right atrium decreases which leads to closure of the foramen ovale.