neonatologu

Question 1

congenital infection - TORCH screen

Answer 1

toxoplasmosis
'other' (syphilis, chickenpox)
rubella 
cytomegalovirus (CMV)
herpes simplex virus (HSV)

Question 2

congenital infection may result in…

Answer 2

IUGR (intrauterine growth restrictions)
brain calcifications
neurodevelopmental delay 
visual impairment
recurrent infections

Question 3

causes of neonate respiratory distress

Answer 3

sepsis
transient tachypnoea of newborn
meconium aspiration

Question 4

transient tachypnoea of newborn

Answer 4

self limiting and common, presents within 1st few hrs life

delay in clearance of fetal lung fluids

Question 5

transient tachypnoea of newborn management

Answer 5

supportive
antibiotics
O2
airway support

Question 6

transient tachypnoea of newborn clinical presentation

Answer 6

grunting
tachynpnoea
o2 requirement
normal gases

Question 7

TTN findings on x-ray

Answer 7

wet lungs
prominent vascular margins
fluid in horizontal lung fissure

Question 8

meconium aspiration - risk factors

Answer 8

post dates
maternal diabetes
maternal HTN
difficult labour

Question 9

meconium aspiration - symptoms

Answer 9

cyanosis
inc work of breathing
grunting
apnoea
floppiness

Question 10

meconium aspiration - investigations

Answer 10

blood gas
septic screen
CXR

Question 11

meconium aspiration CXR findings

Answer 11

chest hyperinflation
flapping diaphragm
coarse opacities
patchy areas of collapse

Question 12

meconium aspiration management

Answer 12

suction below cords
intubation + ventilation 
fluids
IV antib
surfactant
NO
ECMO

Question 13

cyanotic congenital cardiac diseases

Answer 13

truncus arteriosus
transposition of great arteries
tricuspid artresia
tertology of fallot
TAVPD

Question 14

hypoglycamia management

Answer 14

monitor blood glc 
enteral feeds
inc fluis
start IV 10% glc
inc glc concentration 
glucagon 
hydrocortisone

Question 15

hypothermia management

Answer 15

place in incubator
sepsis screen + antib
consider checking thyroid function
monitor glucose

Question 16

jaundice management

Answer 16

if severe may require admission for intensive phototherapy and/or exchange transfusion

incubator and IV fluids may be required

Question 17

birth asphyxia

Answer 17

lack of oxygen at or around birth leads to multiorgan dysfunction

Question 18

causes of birth asphyxia

Answer 18

placental problem 
long, difficult difficulty
umbilical cord prolapse
infection 
neonatal airway problem
neonatal anaemia

Question 19

birth asphyxia stage 1

Answer 19

within mins

cell damage occurs with lack of blood flow and O2

Question 20

birth asphyxia stage 2

Answer 20

reperfusion injury
days-weeks
toxins released from damaged cells

Question 21

hypoxic ischaemic encephalopathy

Answer 21

Pattern of brain injury 2nd to birth asphyxia

Question 22

hypoxic ischaemic encephalopathy management

Answer 22

treat seizures
therapeutic hypothermia
supportive
fluid restriction 
monitor renal + liver failure
resp support 
cardiac support

Question 23

surgical problems seen in term neonates

Answer 23

oesophageal fistula/atresia
duodenal atresia
abdo wall defects
diaphragmatic hernia

Question 24

causes of failure to pass stool

Answer 24

large bowel atresia
imperforate anus +/- fistula
hirschsprunas disease
meconium plug
meconium ileus

Question 25

neonatal abstinence syndrome

Answer 25

withdrawal from physically addictive substances taken by mother in pregnancy

Question 26

neonatal abstinence syndrome management

Answer 26

comfort
morphine
phenobarbitone