neonatology

Question 1

what is necrotising enterocolitis

Answer 1

bacterial invasion of bowel wall leading to necrosis
affects preterm infants in the first few weeks of life

Question 2

when does necrotising enterocolitis typically occur

Answer 2

after the initiation of feeds

Question 3

risk factors for necrotising enterocolitis

Answer 3

formula fed
premature

Question 4

clinical presentation of necrotising enterocolitis

Answer 4

intolerance to feeds
bile stained vomit
distended abdomen
blood in stool

Question 5

xray features for necrotising enterocolitis

Answer 5

distended loops of bowel
thickening of bowel wall
pneumatosis intestinalis - gas in bowel
gas in portal veins

Question 6

what x ray sign shows perforation in necrotising enterocolitis

Answer 6

Pneumoperitoneum

Question 7

management of necrotising enterocolitis

Answer 7

nbm
tpn
abx
surgery

Question 8

complications of necrotising enterocolitis

Answer 8

perforation
peritonitis

Question 9

what is bronchopulmonary dysplasia (BPD)

Answer 9

form of chronic lung disease affecting newborns

Question 10

cause of bronchopulmonary dysplasia (BPD)

Answer 10

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

Question 11

clinical presentation of BPD

Answer 11

increased work of breathing
low o2 sats
poor feeding and weight gain
crackles and wheeze on chest auscultation

Question 12

risk factors for BPD

Answer 12

premature
needing o2 therapy

Question 13

what can be used to prevent risk of BPD

Answer 13

corticosteroids
CPAP

Question 14

management for BPD

Answer 14

sleep study to assess o2 sats
protection against RSV using palivizumab
possible low dose of o2 at home

Question 15

what is meconium aspiration

Answer 15

meconium passed before birth causing babies to inhale and cause aspiration

Question 16

risk factor of meconium aspiration

Answer 16

greater gestational age

Question 17

management for meconium aspiration

Answer 17

cpap
ventilation

Question 18

causes of small bowel obstruction

Answer 18

atresia or stenosis of small intestine
malrotation with volvulus
meconium ileus
meconium plug

Question 19

causes of large bowel ibstruction

Answer 19

hirschprung disease
rectal atresia

Question 20

what is gastroschisis

Answer 20

defect in the abdominal wall causing the intestines to develop outside

Question 21

management for gastroschisis

Answer 21

wrapping exposed intestines with cling film to reduce fluid and body heat loss (prone to dehydration and body loss)
surgery

Question 22

difference between exomphalos and gastroschisis

Answer 22

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

Question 23

what is oesophageal atresia

Answer 23

short section at the top of the oesophagus hasnt formed properly so its not connected to the stomach

Question 24

what is tracheo-osephageal fistula

Answer 24

tends to occur alongside oesophageal atresia
this is when pary of the oesophagus is joined to the trachea

Question 25

what is TORCH infection

Answer 25

infection of the developing foetus or newborn that can occur in utero, during delivery or after birth

Question 26

infectious agents of TORCH infection

Answer 26

toxoplasma gondii other agents e.g. VZV, parvovirus b19, HIV rubella CMV HSV

Question 27

clinical presentation of TORCH

Answer 27

vary depending on underlying infection fever microcephaly low birth weight lethargy / sleepiness hearing loss hepatosplenomegaly cataracts congenital heart disease

Question 28

TORCH infection skin presentation

Answer 28

petechiae or purpura jaundice blueberry muffin rash

Question 29

transmission of torch infection

Answer 29

transmission through placenta while passing through birth canal through breast milk

Question 30

complications of TORCH

Answer 30

preterm birth delayed development physical malformations loss of pregnancy

Question 31

cause of toxoplasmosis

Answer 31

consumption of raw or undercooked meat contact with faeces of recently infected cats

Question 32

management of toxoplasmosis

Answer 32

pyrimethamine (antiparasitic) and sulfadiazine (abx)

Question 33

clinical presentation of toxoplasmosis

Answer 33

retinopathy cerebral calcification hydrocephalus

Question 34

when do infants need to be given protection from chickenpox and what is given

Answer 34

If a mother develops chickenpox shortly before or after delivery prophylaxis acyclovir

Question 35

management for CMV

Answer 35

ganciclovir

Question 36

transmission of listeria from mother to foetus

Answer 36

via placenta

Question 37

causes of listeria

Answer 37

eating unpasteurised milk soft cheese undercooked poultry

Question 38

clinical presentation of listeria

Answer 38

n and v meconium staining of the meconium stained liquor, widespread rash , pneumonia, meningitis, septicaemia

Question 39

effects of gestational diabetes on infant

Answer 39

macrosomia risk of hypoglycaemia risk of asphyxia

Question 40

problems associated with cleft lip and palate

Answer 40

difficulty feeding glue ear and otitis media more common dental problems speech problems

Question 41

management for cleft lip palate

Answer 41

surgery feeding support monitor hearing slt dental hygiene