Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Child Health > Neonatology > Flashcards

Neonatology Flashcards

1
Q

What do TY2 alveolar cells produce surfactant?

A

24-34 weeks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Purpose of surfactant

A

Redcued surface tension in alveoli and prevents them from collapsing
Maximises surface area
Increased lung compliance
Promotes equal expansion of all alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Foramen ovale-> fossa oval is

A 
First breath
Alveoli expands
Decreased pulmonary vascular resistance 
Fall in right atrial pressure 
L>R
Squashes atrial septum 
Functional closure 
Fossa ovalis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ductus arteriosus-> ligamentum arteriosum

A

Increased blood oxygenation with first breath
Drop in circulating prostaglandins
Closure of ductus arteriosus
Ligamentum arteriosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ductus venosum-> ligamentum venosum

A

Umbilical cord is clamped

Reduced blood flow in umbilical veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Hypoxia in neonate

A

Normal in labour and birth
Placenta can’t carry out normal gas exchange during contractions
Extended hypoxia: anaerobic respiration and drop in fetal heart rate
Reduced consciousness and drop in respiratory effort
Hypoxic-ischaemic encephalopathy
Cerebral palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Issues in neonatal resuscitation

A

Hypoxia
Large surface area to weight ratio, get cold very easily
Born wet, so lose heat rapidly
May have meconium in mouth or airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Principles of neonatal resuscitation

A

Warm baby
Calculate APGAR score
Stimulate breathing, neutral position, towel dry, check for meconium
Inflation breaths: 2 cycles of 5, give oxygen if pre-term
Chest compressions: 3:1 with ventilation, if <60bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

APGAR score

A 
Appearance (skin colour)
Pulse
Grimace (response to stimulation)
Activity (muscle tone)
Respiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Delayed umbilical cord clamping

A

Placental transfusion: Fetal blood in placenta enters circulation of baby
Improved Hb, iron stores, blood pressure
Reduction in intraventricular haemorrhage and necrotising enterocolitis
Increase in neonatal jaundice, requiring more phototherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Care immediately after birth

A 
Skin to skin 
Clamp the umbilical cord
Dry the baby 
Keep warm 
VitaminK
Label the baby 
Measure the weight and length
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Vitamin K after birth

A

Babies born with deficiency
IM injection
Stimulate cry- expand lungs
Helps prevent bleeding: intracranial, umbilical stump, GI bleeding
Oral takes longer to act, doses at birth, 7 days, 6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Skin to skin contact after birth

A

Helps warm baby
Improves interaction
Calms baby
Improves breast feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Care after delivery room

A

Initiate breast feeding or bottle feeding as soon as baby is alert enough
Newborn examination within 72 hours
Blood spot test
Newborn hearing test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Blood spot screening

A 
Day 5
Sickle cell disease
Cystic fibrosis 
Congenital hypothyroidism 
Phenylketonuria 
Medium-chain acyl-COA deydrogenase deficiency 
Maple syrup urine disease 
Isovaleric acidaemia
Glutaric aciduria TY1
Homocystin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Newborn examination

A 
Performed within 72hours after birth 
Repeated after 6-8weeks
Ask if baby has passed meconium?
Is the baby feeding ok?
FH of congenital problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Oxygen saturations pre-ductal or post-ductal

A

Before and after ductus arteriosus
No more than 2% difference
Pre-ductal: right hand
Post-ductal: either foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When does the ductus arteriosus close?

A

1-3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

General appearance newborn examination

A

Colour (pink is good)
Tone
Cry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Head examination neonates

A

General appearance: size, shape, dysmorphology, caput succedaneum, cephalohaematoma, facial injury
Occipital frontal circumference
Fontanelles
Sutures
Ears
Eyes: squint, epicanthic folds, purulent discharge
Red reflex: congenital cataracts and retinoblastoma
Mouth: cleft lip or tongue tie
Suck reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Shoulder and arm examination neonates

A 
Shoulder symmetry: clavicle fracture
Arm movements: Erb’s palsy
Brachial pulses
Radial pulses
Palmar creases: Down’s
Digits: clinodactyly 
Sats probe: preductal reading on right wrist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Chest newborn examination

A

Oxygen sats in right wrist and foot
Observe breathing: resp distress, symmetry, stridor
Heart sounds: murmurs, heart sounds, HR, identify which side heart is on
Breath sounds: symmetry, good air entry, added sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Abdomen examination newborn

A

Observe shape: diaphragmatic hernia
Umbilical stump: discharge, infection, periumbilical hernia
Palpate for organometallic, hernias or masses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Genitals examination in newborn

A

Observe for sex, ambiguity, obvious abnormalities
Palpate testes and scrotum: check both are present and descended, check for hernias or hydrocele
Inspect the penis for hypospadias, epispadias, urination
Inspect anus for patency
Ask about meconium and if baby has opened the bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Legs examination newborn

A

Observe the legs and hips for equal movements, skin creases, tone and talipes
Barlow and Ortolani movements; check for clunking, clicking and dislocation of the hips
Count the toes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Back examination newborn

A

Inspect and palpate spin
Curvature, spina bifida, pilonidal sinus
Sacral dimples/pits for tethered spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Reflexes in newborn

A 
Moro reflex
Suckling reflex
Rooting reflex: tickling cheek
Grasp reflex
Stepping reflex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Skin findings in neonatal examination

A 
Haemangiomas
Port wine stains
Mongolian blue spot
Cradle cap
Desquamation 
Erythema toxicum 
Milia
Acne
Naevus simplex
Moles
Transient pustular Melanosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Talipes

A

Clubfoot
Ankles in supinated position, rolled inwards
Positional vs structural

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Positional talipes

A

Muscles slightly tight around ankle
Bones unaffected
Physiotherapy referral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Structural talipes

A

Involves bones of foot and ankle

Requires referral to orthopaedic surgeon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Undescended testes

A

Require monitoring and referral to a urologist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Haemangiomas

A

If near eyes, mouth, or affecting airway
Propanolol
If not, monitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Port wine stains

A

Capillary abnormalities
Pink patches of skin on face
Dont fade, turn a darker red or purple
Can be relate to Sturge-Weber syndrome: visual impairment, learning difficulties, headaches, glaucoma, epilepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Sturge-Weber syndrome

A 
Port wine stains
Visual impairment
Learning difficulties
Headaches
Epilepsy
Glaucoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Clunky or asymmetrical hips

A

Require referral for hip US

To rule out DDH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Cephalohaematomas

A

Require monitoring for jaundice and anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Soft systolic murmur

A

If grade 2 or less
Health neonate
Resolve after 24-48, patent foramen ovale closes shortly after birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Caput succedaneum

A

Oedema on scalp, outside periosteum, so can cross sutures lines
Cause: pressure on scalp during delivery
Self resolves in a few days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Cephalohaematoma

A 
Collection of blood between skull and periosteum 
Traumatic subperiosteal haematoma
Doesn’t cross suture lines 
Self-resolves in a few months 
Risk of anaemia and jaundice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Facial paralysis

A

Forceps delivery
Function resolves within a few months
Neurosurgical input may be required when function doesn’t return

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Erb’s palsy

A 
Injury to C5/6 
Shoulder dystocia, traumatic or in instrumental delivery and large birth weight
Internally rotated shoulder
Extended elbow
Flexed wrist facing backwards (pronated)
Lack of movement in affected arm 
Function returns within a few months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Fractured clavicle

A

Shoulder dystocia, traumatic or instrumental delivery and large birth weight
Noticeable lack of movements or asymmetry of movement in the affected arm
Asymmetry of the shoulders, with the affected shoulder lower than the normal shoulder
Pain and distress on movement of the arm
USS/XRAY
Conservative mx
Potential brachial plexus injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Common organisms in neonatal sepsis

A 
Group B streptococcus (vagina)
E.coli
Listeria
Klebsiella
Staph. Aureus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Risk factors

A 
Vaginal GBS colonisation
GBS sepsis in a previous baby
Maternal sepsis, chorioamnionitis or fever >38
Prematurity, <37weeks
Early rupture of membrane
Prolonged rupture of membranes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Clinical features of neonatal sepsis

A 
Fever
Reduced tone and activity
Poor feeding
Respiratory distress or apnoea
Vomiting
Tachycardia or bradycardia
Hypoxia
Jaundice within 24hours
Seizures
Hypoglycaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Red flags for neonatal sepsis

A

Confirmed or suspected sepsis in mother
Signs of shock
Seizures
Term baby needing mechanical ventilation
Respiratory distress starting >4 hours after birth
Presumed sepsis in another baby in a multiple pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Treatment of presumed sepsis

A

If >1 risk factor or clinical features, monitor observations and clinical condition for at least 12hours
If >2 risk factors or clinical features of neonatal sepsis, start ax
If single red flag give ax within 1 hr, after blood cultures
FBC, CRP
Lumbar puncture if features of meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Ax for neonatal sepsis

A

Benzylpenicillin and gentamicin

If lower risk can give cefotaxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Ongoing mx of neonatal sepsis

A

Check CRP at 24 hours , <10
Blood culture at 36hours, negative
Stop ax
If >10 lumbar puncture needed

Check CRP after 5 days if still on treatment, if lumbar puncture, blood culture and CRP negative and clinically well, stop ax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is prematurity

A

32-37 weeks gestation: moderate to late preterm
28-32: very preterm
<28 extreme preterm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Associations with prematurity

A 
Social deprivations
Smoking
Alcohol
Drugs 
Overweight or underweight mother
Maternal co-morbidities 
Twins
Personal or FH of prematurity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Management of prematurity before birth

Women with a history of pre-term birth or US demonstrating a cervical length of 25mm or less before 24 weeks gestation

A

Prophylactic vaginal progesterone
Prophylactic cervical cerclage: suture to close cervix
Tocolysis with nifedipine
Maternal corticosteroids: befor 35weeks, reduce neonatal mortality
IV Mgsulphate: protect baby’s brain, given before 34weeks
Delayed cord clamping or cord milking: increased circulating volume and Hb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Issues in early life of premature babies

A 
RDS
Hypothermia
Hypoglycaemia
Poor feeding
Apnoea and bradycardia
Neonatal jaundice
Intraventricular haemorrhage
Retinopathy of prematurity
Necrotising enterocolitis
Immature immune system and infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

When to suspect hypoxic-ischaemic encephalopathy

A

Events that could lead to hypoxia during the perinatal or intrapartum period
Acidosis on umbilical artey blood gas
Poor APGAR score
Evidence of multi organ failure

56
Q

Causes of hypoxic ischaemic encephalopathy

A 
Anything that leads to brain asphyxia 
Maternal shock 
Intrapartum haemorrhage
Prolapsed cord
Nuchal cord
57
Q

What is the staging for HIE?

A

Sarnat staging

58
Q

Mild HIE

A

Poor feeding, generally irritability and hyper-alert
Resolves within24hrs
Normal prognosis

59
Q

Moderate HIE

A

Poor feeding, lethargic, hypotonic and seizures
Can take weeks to resolve
Up to 40% develop cerebral palsy

60
Q

Severe HIE

A

Reduced consciousness, apnoea, flaccid and reduced/absent reflexes
50% mortality
90% develop cerebral palsy

61
Q

Therapeutic hypothermia

A

HIE mx
Neonatal ICU: cooling blanket and cooling hat
33-34 target, use rectal probe for 72hours
Baby is gradually warmed to normal temperature after 6 hours

62
Q

Intention of therapeutic hypothermia

A

Inflammation and neurone loss
Acute hypoxic injury
Reduces risk of cerebral palsy, developmental delay, learning disability, blindness and death

63
Q

Physiological neonatal jaundice

A

Fetal RBC break down more rapidly
Bilirubin excreted via placenta, at birth rise in bilirubin
Mild yellowing of skin and sclera at 2-7days of age
Usually resolves completely by 10 days

64
Q

Causes of increased production of bilirubin

A 
HDN
ABO incompatibility 
Haemorrhage 
Intraventricular haemorrhage 
Cephalohaematoma
Polycythemia
Sepsis and DIC
G6PD deficiency
65
Q

Depressed clearance of bilirubin

A 
Prematurity
Breast milk jaundice
Neonatal cholestasis
Extrahepatic biliary atresia
Endocrine disorders (hypothyroid and hypopituitary)
Gilbert syndrome
66
Q

Jaundice within 24 hours of birth

A

Treatment for sepsis

Pathological

67
Q

Jaundice in premature neonates

A

Immature liver

Increases complications, kernicterus (brain damage)

68
Q

Breast milk jaundice

A

Components of breast milk inhibit ability of liver to process bilirubin
Inadequate breastfeeding: slow passage of stool (dehydration), increased absorption of bilirubin in intestines
Encourage breastfeeding though

69
Q

HDN

A

Cause of haemolysis and jaundice in neonate
Rh-ve mother makes antibodies against Rh+ve baby
Haemolysis
Anaemia
High bilirubin

70
Q

Prolonged jaundice

A

> 14 days in full term babies
21 days in premature babies
Check for biliary atresia, hypothyroidism, G6PD deficiency

71
Q

Investigations for neonatal jaundice

A

FBC and blood film; polycythemia or anaemia
Conjugated bilirubin: biliary atresia
Blood type testing
Direct Coombs test for haemolysis
Thyroid function tests
Blood and urine cultures if infection is suspected
G6PD deficiency

72
Q

Phototherapy for neonatal jaundice

A

Converts unconjugated bilirubin into isomers that can be excreted into bile and urine without require it conjugation in the liver
Eye-patches to protect eyes
Light-box shines UV light on baby’s skin
Double phototherapy involves two light boxes
Bilirubin is closely monitored during treatment
Rebound bilirubin measured 12-18hours after stopping

73
Q

Kernicterus

A

Bilirubin crosses blood brain barrier
Direct damage to CNS
Cerebral palsy, learning disability, deafness

74
Q

Apnoea in neonates

A

Breathing stops for >20 seconds
Oxygen desaturation or bradycardia
Accompanied by a period of bradycardia
Very common in premature neonates, <28 weeks gestation

75
Q

Causes of apnoea of prematurity

A 
Immaturity of ANS that controls respiration and HR
Infection 
Anaemia
Airway obstruction 
CNS pathology, seizures or headaches
GORD
Neonatal abstinence syndrome
76
Q

Management of apnoea of prematurity

A

Apnoea monitors
Tactile stimulation
IV caffeine
Episodes will settle as baby grows and develops

77
Q

Retinopathy of prematurity

A

Mostly affects babies born before 32weeks gestation
Abnormal development of retinal blood vessels
Scarring, retinal detachment, blindness
Treatment can prevent blindness

78
Q

Pathophysiology of retinopathy of prematurity

A

Retinal blood vessel development: 16weeks-40weeks
Stimulated by hypoxia
In pre-term, less hypoxia exposure so stimulation removed
Hypoxic environment returns: excessive blood vessels (neovascularisation) and scar tissue
Abnormal blood vessels regress
Scar tissue causes retinal detachment

79
Q

Assessment of retinopathy of prematurity

A

Stage 1: slightly abnormal vessel growth
Stage 5: complete retinal detachment
Plus disease: additional findings, tortuous vessels, hazy vitreous humour

80
Q

Retina divided into three zones

A

Zone 1: optic nerve and macula
Zone 2: edge of zone 1 to ora serrata (pigmented border between retina and ciliary body)
Zone 3: outside ora serrata

81
Q

Screening for retinopathy of prematurity

A

Babies born before 32 weeks or <1.5kg
At 30-31 weeks gestational age in babies born before 27weeks
4-5 weeks of age in babies born after 27weeks
Screening every 2 weeks until vessels reach zone 3

82
Q

Treatment of retinopathy of prematurity

A

First line: transpupillary laser photo coagulation and reverse neovascularisation

Cryotherapy
Injections of intravitreal VEGF inhibitors
Surgery if retinal detachment occurs

83
Q

Respiratory distress syndrome

A

Affects premature neonates
Those born before lungs start producing adequate surfactant
Occurs below 32weeks
CXR shows ground glass appearance

84
Q

Pathophysiology of respiratory distress syndrome

A 
Less surfactant
High surface tension in alveoli 
Atelectasis 
Cant expand
Inadequate gas exchange
Hypoxia, hypercapnia, respiratory distress
85
Q

Management of respiratory distress syndrome

A

Antenatal steroids (i.e. dexamethasone)
Increase surfactant production
Reduce incidence and severity

86
Q

Management of respiratory distress syndrome in premature neonates

A

Intubation and ventilation to assist breathing
Endotracheal surfactant
CPAP
Supplementary oxygen 91-95%

87
Q

Short term complications of RDS

A 
Pneumothorax 
Infection
Apnoea
Intraventricular haemorrhage 
Pulmonary haemorrhage
Necrotising enterocolitis
88
Q

Long-term complications of RDS

A

Chronic lung disease of prematurity
Retinopathy of prematurity
Neurological, hearing and visual impairment

89
Q

Risk factors for necrotising enterocolitis

A 
Very low birth weight or very premature
Formula feeds 
Respiratory distress and assisted ventilation 
Sepsis
PDA or congenital heart defects
90
Q

Presentation of necrotising enterocolitis

A 
Intolerance to feeds
Vomiting, green bile
Generally unwell
Distended, tender abdomen 
Absent bowel sounds
Blood in stools 
If perforated: signs of shock
91
Q

Investigations for necrotising enterocolitis

A

Bloods: FBC, CRP, capillary blood gas, blood culture
AXR: supine position, lateral, ap, lateral decubitus

92
Q

AXR of necrotising enterocolitis

A 
Dilated loops of bowel 
Bowel wall oedema (thickened bowel walls)
Pneumatosis intestinalis 
Pneumoperitoneum: indicates perforation 
Gas in portal veins
93
Q

Management of necrotising enterocolitis

A 
Nil by mouth 
IV fluids
TPN 
NG tube 
Surgical team 
Surgery to remove dead bowel tissue 
Temporary stoma if significant bowel is removed
94
Q

Complications of necrotising enterocolitis

A 
Perforation and peritonitis
Sepsis
Death
Strictures
Abscess formation
Recurrence
Long-term stoma
Short bowel syndrome after surgery
95
Q

Substances that can cause neonatal abstinence syndrome

A 
Opiates
Methadone
 Benzodiazepines
Cocaine
Amphetamines
Nicotine or cannabis
Alcohol
SSRI antidepressants
96
Q

When do withdrawal symptoms occur?

A

24hrs-21days:
Methadone
Benzodiazepines

3-72hours after birth: 
Opiates 
Diazepam 
SSRI
Alcohol
97
Q

CNS signs and symptoms of neonatal abstinence syndrome

A 
Irritability
Increased tone
High-pitched cry
Not settling 
Tremors
Seizures
98
Q

Vasomotor and resp signs and symptoms of neonatal abstinence syndrome

A

Yawning
Sweating
Unstable temperature and pyrexia
Tachypnoea (fast breathing)

99
Q

Metabolic and GI signs and symptoms of neonatal abstinence syndrome

A

Poor feeding
Regurgitation or vomiting
Hypoglycaemia
Loose stools with a sore nappy area

100
Q

Management of neonatal abstinence syndrome

A

Monitoring on NAS chart for at least 3 days
Urine sample from neonate
Oral morphine sulphate for opiate withdrawal
Oral phenobarbitone for non-opiate withdrawal

101
Q

Management of neonatal abstinence syndrome

A

Test for Hep B/C and HIV
Safeguarding and social service involvement
Safety-net advice for readmission if withdrawal signs and symptoms occur
Follow-up from paediatrics, social services, health visitors and the GP
Support for the mother to stop using substances
Check suitability for breastfeeding

102
Q

Effects of alcohol in early pregnancy

A 
<3 months of pregnancy
Miscarriage 
Small for dates
Pre-term delivery 
Fetal alcohol syndrome
103
Q

Fetal alcohol syndrome characteristics

A 
Microcephaly
Thin upper lip 
Smooth flat philthrum 
Short palpable fissure 
Learning disability
Behavioural difficulties 
Hearing and vision problems 
Cerebral palsy
104
Q

Congenital rubella syndrome

A

Mother becomes infected during pregnancy
MMR vaccine for women thinking about pregnancy
Pregnancy women shouldn’t be given vaccine

105
Q

Features of congenital rubella syndrome

A

Congenital cataracts
Congenital heart disease (PDA and pulmonary stenosis)
Learning disability
Hearing loss

106
Q

Chickenpox in pregnancy

A

Fetal varicella syndrome
Severe neonatal varicella infecton if mum infected around delivery
Varicella pneumonitis, hepatitis, encephalitis
Give vaccine before or after pregnancy

107
Q

Exposure to chickenpox in pregnancy

A

Safe if previously had chickenpox
Test VZV IgG levels, if positive they’re safe
If not immune, give IV varicella Ig as prophylaxis, treat within 10 days of exposure
When rash starts to develop, treat with oral aciclovir if present within 24hrs and are <20 weeks gestation

108
Q

Features of congenital varicella syndrome

A

Infection within 28 weeks of gestation
Fetal growth restriction
Microcephaly, hydrocephalus and learning disability
Scars and significant skin changes following dermatomes
Limb Hypoplasia
Cataracts and eye inflammation (chorioretinitis)

109
Q

Features of congenital CMV

A 
Fetal growth restriction
Microcephaly
Hearing loss
Vision loss
Learning disability
Seizures
110
Q

Congenital toxoplasmosis

A

Intracranial calcification
Hydrocephalus
Chorioretinitis

111
Q

Congenital Anika syndrome features

A

Microcephaly
Fetal growth restriction
Other intracranial abnormalities: ventriculomegaly, cerebellar atrophy
Pregnant women in contact should be tested with viral PCR and antibodies to Zika virus

112
Q

Risk factors for sudden infant death syndrome

A

Prematurity
Low birth weight
Smoking during pregnancy
Male baby (only slight increased risk)

113
Q

Minimising the risk of sudden infant death syndrome

A

Put baby on back
Keep head uncovered
Place their feet at foot of bed to prevent sliding Godwin
Keep cot clear
Maintain comfortable room temperature
Avoid smoking and handling baby after smoking
Avoid co-sleeping, particularly on sofa or chair
Lullaby trust
Care of next infant team

114
Q

Definition of neonate

A

<4 weeks

115
Q

Very low birth weight:

Extremely low birth weight:

A

Very low birth weight: <2.5kg

Extremely low birth weight: <50kg

116
Q

Congenital diaphragmatic hernia

A

Incomplete formation of diaphgram
Abdominal viscera herniate
Stops lungs from inflating: pulmonary Hypoplasia and HTN
Respiratory distress after birth

Use anaesthetic drugs to stop breathing
Secure airway

117
Q

Management of pre-term baby

A

Ventilation
NG tube: unable to coordinate suck and swallow due to immature brain
TPN, central line (umbilical)
Incubator: heats and humidifies air
Convection, lying in-utero position to protect joints

118
Q

Risk factors for hip problems

A

Breech baby
Connective tissue disorder
Talipes/ club foot

119
Q

Hearing screen

A

Otoacoustic emissions

Automated auditory brainstem response

120
Q

Capillary haemangioma

A

Strawberry naevus
Grows then involuntes
Can be treated with propanolol

121
Q

Toxic erythema of the newborn

A

Rash
Begins on face and spreads to affect trunk and limbs
Palms and soles usually not affected
Waxes and wanes over several days

122
Q

Positional talipes

A

No medical intervention needed

Foot rests down and inwards

123
Q

Minor breastfeeding problems

A

Frequent feeding
Nipple pain: poor latch
Blocked duct (milk bleb): nipple pain when breastfeeding
Nipple candidiasis

124
Q

Management of blocked duct breastfeeding

A

Continue breastfeeding
Positioning advice
Breast massage

125
Q

Treatment for nipple candidiasis

A

Miconazole cream for mum

Nystatin suspension for baby

126
Q

When to treat mastitis

A

Systematically unwell
Nipple fissure present
Symptoms don’t improve after 12-24hrs of effective milk removal
Culture indicates infection

127
Q

Management of mastitis

A

Flucloxacillin 10-14days
Continue breastfeeding or expressing

If it develops into breast abscess: incision and drainage

128
Q

Features of breast engorgement

A

Occurs in first few days after infant is born
Almost always affects both breasts
Pain/discomfort typically worse just before feed
Poor milk flow
Infant may find it difficult to attach and suckle
Fever settles within 24hrs
Red breast

129
Q

Management of breast engorgement

A

Hand expression of milk

130
Q

Complications of breast engorgement

A

Blocked milk ducts
Mastitis
Difficulties with breastfeeding and milk supply

131
Q

Features of Raynaud’s disease of the nipple

A

Pain is intermittent and present during and immediately after feeding
Blanching of nipple may be followed by cyanosis and/or erythema
Nipple pain resolves when nipples return to normal colour

132
Q

Management of Raynaud’s disease of nipple

A

Minimising exposure to cold
Heat packs following breastfeed
Avoid caffeine
Stop smoking

Oral nifedipine

133
Q

Drug contraindications to breastfeeding

A 
Antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides
Psychiatric drugs: lithium, benzodiazepines
Aspirin
Carbimazole
Methotrexate
Sulphonylureas
Cytotoxic drugs
Amiodarone
134
Q

Contraindications of breastfeeding

A

Galactosaemia
Drugs
Viral infections

135
Q

TORCH infections

A 
Toxoplasma Gondii
Other: VZV, Parvovirus b19, listeriosis
Rubella
CMV
Herpes/ HIV
Syphilis
136
Q

Oesophageal atresia

A

Associated with tracheo-oesophageal fistula and poly hydraminos
May6 present with choking and chaotic spells following aspiration
VACTERL associations

Child Health (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions