neonatology Flashcards
what is necrotising enterocolitis
bacterial invasion of bowel wall leading to necrosis
affects preterm infants in the first few weeks of life
when does necrotising enterocolitis typically occur
after the initiation of feeds
risk factors for necrotising enterocolitis
formula fed
premature
clinical presentation of necrotising enterocolitis
intolerance to feeds
bile stained vomit
distended abdomen
blood in stool
xray features for necrotising enterocolitis
distended loops of bowel
thickening of bowel wall
pneumatosis intestinalis - gas in bowel
gas in portal veins
what x ray sign shows perforation in necrotising enterocolitis
Pneumoperitoneum
management of necrotising enterocolitis
nbm
tpn
abx
surgery
complications of necrotising enterocolitis
perforation
peritonitis
what is bronchopulmonary dysplasia (BPD)
form of chronic lung disease affecting newborns
cause of bronchopulmonary dysplasia (BPD)
usually caused by mechanical ventilation and long term use of o2
usually occurs when newborn’s lungs are underdeveloped at birth and they require a ventilator or oxygen therapy for support
clinical presentation of BPD
increased work of breathing
low o2 sats
poor feeding and weight gain
crackles and wheeze on chest auscultation
risk factors for BPD
premature
needing o2 therapy
what can be used to prevent risk of BPD
corticosteroids
CPAP
management for BPD
sleep study to assess o2 sats
protection against RSV using palivizumab
possible low dose of o2 at home
what is meconium aspiration
meconium passed before birth causing babies to inhale and cause aspiration
risk factor of meconium aspiration
greater gestational age
management for meconium aspiration
cpap
ventilation
causes of small bowel obstruction
atresia or stenosis of small intestine
malrotation with volvulus
meconium ileus
meconium plug
causes of large bowel ibstruction
hirschprung disease
rectal atresia
what is gastroschisis
defect in the abdominal wall causing the intestines to develop outside
management for gastroschisis
wrapping exposed intestines with cling film to reduce fluid and body heat loss (prone to dehydration and body loss)
surgery
difference between exomphalos and gastroschisis
exomphalos - covered by a thin membrane and it is located more centrally
gastroschisis - not covered by a thin membrane and is located to the right of the umbilical cord
what is oesophageal atresia
short section at the top of the oesophagus hasnt formed properly so its not connected to the stomach
what is tracheo-osephageal fistula
tends to occur alongside oesophageal atresia
this is when pary of the oesophagus is joined to the trachea
what is TORCH infection
infection of the developing foetus or newborn that can occur in utero, during delivery or after birth
infectious agents of TORCH infection
toxoplasma gondii
other agents e.g. VZV, parvovirus b19, HIV
rubella
CMV
HSV
clinical presentation of TORCH
vary depending on underlying infection
fever
microcephaly
low birth weight
lethargy / sleepiness
hearing loss
hepatosplenomegaly
cataracts
congenital heart disease
TORCH infection skin presentation
petechiae or purpura
jaundice
blueberry muffin rash
transmission of torch infection
transmission through placenta
while passing through birth canal
through breast milk
complications of TORCH
preterm birth
delayed development
physical malformations
loss of pregnancy
cause of toxoplasmosis
consumption of raw or undercooked meat
contact with faeces of recently infected cats
management of toxoplasmosis
pyrimethamine (antiparasitic) and sulfadiazine (abx)
clinical presentation of toxoplasmosis
retinopathy
cerebral calcification
hydrocephalus
when do infants need to be given protection from chickenpox and what is given
If a mother develops chickenpox shortly
before or after delivery
prophylaxis acyclovir
management for CMV
ganciclovir
transmission of listeria from mother to foetus
via placenta
causes of listeria
eating unpasteurised milk
soft cheese
undercooked poultry
clinical presentation of listeria
n and v
meconium staining of the meconium stained liquor, widespread rash , pneumonia, meningitis, septicaemia
effects of gestational diabetes on infant
macrosomia
risk of hypoglycaemia
risk of asphyxia
problems associated with cleft lip and palate
difficulty feeding
glue ear and otitis media more common
dental problems
speech problems
management for cleft lip palate
surgery
feeding support
monitor hearing
slt
dental hygiene
