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peds > neonatology > Flashcards

neonatology Flashcards

1
Q

APGAR GRADINE

A

out of 10

7-10 - excellent
4-6- moderately depressed
<4 - severely depressed

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2
Q

describe HIE grade 2

A 
tendon reflexes can be overactive 
reudcued by not absent spontanous movement 
seizures 
later on can have some form of delay 
mild hypotonia 
parsympathetic predominate 
primitve refelxes weak or absent
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3
Q

HIE 3

A 
no seizures 
hypotonia 
apnea 
flaccidity 
HR variables 
associated with epilepsy later on and CP (quadriplegic type)
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4
Q

meconium aspiration and diagnosis and when does it occur

A

in the womb the bay struggles for oxygen this triggers parasympathetic system which relaxes the anal sphincter and meconium is released and baby swallows it. meconium is irritating to the lungs so a lot of babies are born with surfactant deficiency. it typically occurs during birth when the fetus is stressed during labour especially when baby is passed due date

dx

  • looking at vocal chords for staining
  • greenish amniotic fluid
  • x ray - streakiness of lungs difficulty breathing
  • bradycardia
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5
Q

physiological weight loss of the newborn RF

A

breastfed babies loose more

less than 8% body weight and most prominent on 3/4th day, should be compnesated around 8/14 days after birth

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6
Q

what can be a cause of fever in neonates

A

infection
overheating
dehydration

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7
Q

how can you measure dehydration

A

dry diaper for >6 hours or less than 6 wet nappies

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8
Q

omphalitis

A

infection of umbilical stump

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9
Q

treatment of thirsty fever

A

oral rehydration with h20 or 5% if less than 10%

if >10% then IV 5%

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10
Q

risk factor of C-Section

A

intracranial hemorrhage
more breathing problems as more fluid in the lugs as it hasnt been squeezed out by natural birth

hypoglactia of the mother

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11
Q

causes of a big baby

A

diabetics
post term
multiparity

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12
Q

adaptation syndrome def

A 
observed in healthy
neonates in the first week after birth.
They reflect the physiologic adaptation
for extrauterine life but may easily evolve —
to pathology. |
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13
Q

normal values of neonatal jaundice (uncojugated)

A

normal -<200

pretetm - <240

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14
Q

diagnosis of thirsty fever

A

hypernatremia

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15
Q

which adaptation syndromes are more common in premies

A

sclerodema neonatorum

sclerema neonatorum- only in premies and more severe

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16
Q

post term baby defiton

A

> 42 weeks

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17
Q

signs of post term

A 
hands of 
long nails 
lots of hair 
visible creases on palms and soles 
meconium staining on skin 
no lanugo 
more alert+ wide eyed
dry peeling skin 
minimal sc fat
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18
Q

diabeic mother babies

A 
big babies >4000
can be at risk for hypoglycemia 
red skin, plethoric face and visceromegaly 
polyglobulia - viscosity 
hyperbilirubinemia- excessive breakdown 
RDS- impaired surfactant synthesis
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19
Q

retained sweat glands and oil glands

A

miium - oil glands
miliara crystallina- retained sweat glands small vesicles with clear fluid and can become infected alba/rubra needs treatment

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20
Q

bonn nodules

A

retained salivary glands yellowish in colour don’t need treatment

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21
Q

naevi flammei

A

capillary hemangiomas on the glabelle

and the neck disappearing first year

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22
Q

when should jaundice appear

A

after the first day, pathological if appears 24 h within birth

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23
Q

what type of jaundice is the physiological jaundice

A

flavin rubin( these babies are more redder)

24
Q

rubin vs icter

A

rubin - don’t have anemia

icter- have anemia so pale

25
Q

what is the link between hypothyroidism and jaundice

A

affects the conjugation process

26
Q

rbc span in baby

A

70 days

27
Q

what % should conjugated br be

A

no more than 20% of the total br

28
Q

deposition of br in BG can lead to

A

dystonic cp? its in my book

29
Q

adr of phototherapy

A

bronze baby syndrome- benign
corneal damage
loose stools

30
Q

erythroblastosis fetalis

A

‘hemolytic disease of newborn’ mothers ab’s attacking baby

31
Q

what are the features of hemolytic disease of newborn (exam question)

  1. what can lead to hemoltic disease of newborn
A
  • hepat/splenomegaly - RES working overime, liver trying to make more rbc etc
  • increased LDH (increased in liver diseases and most notably liver diseases due to hemolysis)
  • elevated reticulocyte count(needs time so you won’t see on the first day )
  • hydrops fetalis - more severe form

any time the 2 bloods mix-so even abortions,miscarriages, proceudres like CVS and amniocentiesis

32
Q

rf for intracranial hemorrhage

A

premature babies
babies head too big to fit
precipitate birth

33
Q

treatMent for brachial plexus injury

premature baby care

A

vasodilators, anticholinesterases (nivalin), splinting whilst asleep
Physiotherapy
Massage

25- 27 degrees but if baby <1500 32 in incubator
feed with 120 cal per kg
may need NG tube if <1500 because poor suck reflex

34
Q

using too much force whilst delivering is risk for

A

clavicular fracture
Brachial plexus trauma
Spinach cord injury - very rare but life threatening (clinical picture is similar to SMA, absolutely floppy baby, breathing problems
SCM injury

35
Q

Nurses for clavicular fracture

prophylactic pre term baby stuff

A

does not need treatment

vit k injection from birth
vit d - 2000 units day 7 or day 10 (book)
iron supplementation after 2/3 months

36
Q

clavicular fracture

A

reflexes preserved

asymmetric moro reflex

37
Q

neonatal sepsis age

A

<4 weeks

38
Q

classification of neonatal sepsis and common causes

A

early onset: up to 1 week group b strep and gram - species

late onset:>1 week most likely staphy

39
Q

risk factor for early sepsis

A

maternal infection UTI
chorioamnionitis
premature
meconium staining

40
Q

risk factot for late spesis

being large for gestational age risks

A

prolonged stay in hospital with catheters, nasal cannulas, GI tract pathology

birth injuries as bigger, fracture, SCM, also deleyaed development, malformations of heart and brain

41
Q

diagnosis of sepsis

A

take samples from everywhere
bloods- cbc, thrombocytopenia + anemia , inflammatory markers
x ray - pneumonia

42
Q

common agents of neonatal meningitis

A

e. coli, group b. listeria monocytogenes

43
Q

crieteria for neonatal meningitis LP

A

> 30 leukocytes
CSF <50% serum glucose
protein >1.2 (i think not very clear)

44
Q

age for NEC

A

1-2 weeks of life

45
Q

key feature of NEC and complications and causes + rf

A

almost always premies, translocation of gut bacteria to blood stream

don’t know the exact cause but can be associated with blood transfusions. RF hypoxia at birth, premies, formula fed babies

strictures, perforation, short bowel syndrome

46
Q

presentation of NEC

A 
Like sepsis
Abdominal distention + redness of abdomen 
Increased residual gastric content 
Biliary vomiting (can be bloodstained )
Bloody diarrhoea
47
Q

DIAGNOSIS OF NEC + treatment

A

x ray to see air loops (pneumoperitoneum, dilated bowel loops) + bloods
AB’S
noenteral feeding
abdominal decompression (gastric tube + enema)
Giving supplemental oxygen (if abdomen is so swollen it interferes with breathing )

48
Q

parrots pseudoparlaysis

A

congenital syphilis

as a result of osteochondriits and loss of movements of affected limb

49
Q

signs of phrenic nerve palsy

A

difficulty breathing
baby also has brachial plexus pathology
respiratory distress signs - tachypnea

50
Q

premies features

A
  1. absent sc fat (like post term)
  2. abundant lanugo
  3. deformed ears (stuck)
  4. short nails
  5. prominent labia minora
  6. boys - cryptorchidism
  7. absent vernix caseosa
  8. limbs less felxed than a term baby
51
Q

Vernix caseosa

A

Vernix caseosa is a white, creamy, naturally occurring biofilm covering the skin of the fetus during the last trimester of pregnancy. Vernix coating protects the newborn skin and facilitates extra-uterine adaptation of skin in the first postnatal week if not washed away after birth.

52
Q

symmetrical retardation vs asymmetrical retardation

A

symmetrical: happens early on (congenital) all 3 parameters affected
asymmetrical: main problem is the weight then length etc and happens later on in pregnancy e.g preclampsia, preterm labour and undernutriton

53
Q

rules for premature baby values

A

by 38 week every baby should be 2,500, for every 2 weeks behind subtract 250g

54
Q

normal bw range

A

2, 500- 4000

or 3-500

55
Q

physiological decline of hb

A

at 3 motnhs 105-120

56
Q

ballard score

A

The Ballard score is based on the neonate’s physical and neuromuscular maturity and can be used up to 4 days after birth (in practice, the Ballard score is usually used in the first 24 hours). The neuromuscular components are more consistent over time because the physical components mature quickly after birt

peds (26 decks)

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