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FOP/TAS > Neonatology > Flashcards

Neonatology Flashcards

1
Q

Embryo defintion

A

Fertilised ovum, until 9w

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2
Q

Fetus definition

A

fertilised ovum, from 9w until delivery

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3
Q

Still birth definition

A

fetal death and expulsion >24w

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4
Q

Abortion definition

A

fetal death <24w

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5
Q

Neonatal mortality rate

A

number of deaths of LIVE born infants within the 1st 28 days per 1000 live births

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6
Q

Infant mortality rate

A

number of deaths between birth and 1 year per 1000 live births

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7
Q

Perinatal mortality rate

A

number of still births and early neonatal deaths within the first 7 days per 1000 live AND still births

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8
Q

Low birth weight

A

<1500g

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9
Q

Presentation of CMV infection

A

CNS - periventricular calcification

Ophthal - chorioretinitis

Sensorineural deafness

Hepatosplenomegaly

Jaundice

Pneumonitis

Thrombocytopenia with petechia +/- purpura

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10
Q

Rx CMV

A

oral valganciclovir or IV ganciclovir

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11
Q

Ix CMV

A

PCR amplification for viral DNA
- amniotic fluid/blood/urine/CSF or saliva

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12
Q

Classic triad of toxoplasmosis

A

Hydrocephalus
Chorioretinitis
Diffuse intracranial calcifications

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13
Q

Ix for toxoplasmosis

A

Reference serology test
- IgM and IgG

IgM +ve indicates active infection
IgG becomes +ve after 2w and stay +ve for life

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14
Q

Rx for toxoplasmosis

A

If fetal infection status not known
- Spiramycin
- Cont until term of fetal infection status documented

If fetal infection suspected or documented
- Pyrimethamine / Sulfasdiazine / Folinic acid
- Rx until 12m of age

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14
Q

Presentation congenital syphilis

A

Rash
Desquamation of soles of hands & feet
Metaphyseal bone lesions

Other features same as toxoplasmosis/CMV

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15
Q

Fetal varicella syndrome features

A

Limb hypoplasia
Microcephaly
Cataracts
Skin scarring (pale yellow dermatomal scars)
IUGR

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16
Q

Rx fetal varicella

A

Prophylaxis
- IVIG following exposure

Rx
- IV aciclovir

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17
Q

Complications of fetal varicella

A

2y bacterial infection (strep A)
Thrombocytopenia
Pneumonia
Purpura fulminans - subcut vasculitis
Cerebellitis

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18
Q

Congenital parvovirus causes …?

A

red cell aplasia > hydrops fetalis

19
Q

Physioogy of PPHN

A

failure of pulmonary vascular resistance to fall within the infants first breaths, so the fetal pattern of left to right shunting across the FO and DA persists, so intrapulmonary shunting and further hypoxia occurs

20
Q

Ix for haemorrhagic disease of the newborn

A

Prolonged PT and APTT

FBC - normal platelets and fibrinogen

Clotting factors II, VII, IX and X all low

21
Q

Rx of haemorrhagic disease of the newborn

A

Vit K and FFP (need FFP becuase Vit K doesnt correct clotting times quickly enough

22
Q

Newborn hearing screening

A
  1. Automated otoacoustic emissions test
  2. Automated auditory brain stem response (AABR)
23
Q

When does blood spot in CF babies become unreliable

A

if done after 8w

24
Q

when to do blood spot if baby needs transfusion after birth

A

pre-transfusion and 3 days after the last transfusion

25
Q

unavoidable repeat sampling of blood spot

A

<32 weeks - need repeat day 21

Bortderline TSH results - repeat day 7-10 after 1st sample

26
Q

Gestation indicated for antenatal steroids

A

24 - 34+6 weeks

27
Q

survival rates of premature infants with active care

A

<21w - 0%
22w -10%
23w - 40%
24w - 60%
26w - 80%

28
Q

dose regime of antenatal steroids

A

betamethasone 12mg - 2 doses 2x hours apart

dexamethasone 6mg - 4 doses 12 hours apart

29
Q

gestation indicated for antenatal Mg sulf

A

< 32 w

30
Q

Most common organism causing EOS

A

Group B strep - Streptococcus agalactiae

31
Q

Screening criteria for ROP

A

<31 weeks gestational age OR <1500g BW

32
Q

Timing of 1st screen for ROP

A

If born < 31 weeks -
Between 31+0 and 31+6 postmenstrual age, or at 4w completed weeks postnatal age (whichever is LATER)

If born >31 weeks and < 1500g -
36 weeks postmenstrual age, or 4 weeks postnatal age (whichever is SOONER)

33
Q

Pathophysiology of ROP

A

Secondary to interruption of the normal process of retinal blood vessel development following preterm birth

  1. Hyperoxia has a detrimental effect on the immature retina
  2. Retinal ischaemia drives vaso-proliferation
34
Q

Grading of IVH

A

I - restricted to subependymal/germinal matrix

II - expansion into the lateral ventricles but <50% and remain norma size

III - extension into dilated ventricles

IV - grade III with parenchymal haemorrhage

35
Q

Most common affected sites in NEC

A

terminal ileum/caecum/ascending colon

36
Q

Rx PDA

A

Prostaglandin synthase inhibitor - pcm or ibuprofen

Then surgical ligation if unsuccessful

37
Q

surrogate measure for bilirubin production

A

carbon monoxide

38
Q

breakdown products of haemoglobin

A

Fe
Globin
Carbon monoxide
Biliverdin

39
Q

Interim product of haemoglobin breakdown to bilirubin

A

Biliverdin

40
Q

What is used to break down haemoglobin to biliverdin

A

haem oxygenase

41
Q

What is used to convert biliverdin to bilirubin

A

biliverdin reductase enzyme

42
Q

What does unconjugated bilirubin join with in plasma

A

albumin

43
Q

enzyme responsible for conjugating bilirubin in the liver

A

uridine disphosphate glucuronyl transferase (UGT)

44
Q

what happens to conjugated bilirubin once it has been excreted in bile from the liver

A

it is hydrolysed in the gut to form urobilinogen and stercobilinogen. also is recycled into the enterohepatic circuation (most)

FOP/TAS (25 decks)

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