Neonatology

Question 1

Impact of antenatal ACE inhibitor use?

Answer 1

Causes renal damage (sometimes irreversible)

Question 2

Impact of antenatal sodium valproate use?

Answer 2

Causes neural tube defects

Question 3

Impact of antenatal warfarin use?

Answer 3

Hypoplastic nasal bridge
Chondrodysplasia
CNS malformations
Risk of bleeding in newborn

Question 4

4 criteria of HIE?

Answer 4

• evidence of metabolic acidosis (UA pH <7 and base deficit >12 at delivery)
• early onset of severe or moderate neonatal encephalopathy in infants >34 weeks
• cerebral palsy of the spastic quadriplegic or dyskinetic type
• exclusion of other identifiable aetiologies (e.g. trauma, coagulation disorders, infection, genetic disorders)

Question 5

Overview of neonatal alloimmune thrombocytopenia?

Answer 5

Mum is HPA1A positive usually
If mum is negative and dad is positive, the mum produces IgG against the paternal feral platelets, which leads to thrombocytopenia
Only IgG crosses the placenta, and the transfer occurs towards the end of pregnancy (gives passive immunity for the first 6 months)

Question 6

Suspected sepsis and salmon-pink papules?

Answer 6

Listeria monocytogenes
- susceptible to benpen and gentamicin, not susceptible to cephalosporins

Question 7

What is measured to screen for SCID in newborn screening tests?

Answer 7

T cell receptor excision circles (TRECs) and Kappa receptor excision circles (KRECs)
Newly developed T cells mean TRECs will be present, newly developed B cells mean KRECs will be present