Neonatology

Question 1

Before how many weeks gestation is a child considered premature?

Answer 1

Before 37 weeks

Question 2

What are some symptoms of neonatal sepsis?

Answer 2

Fever
Reduced tone and activity
Poor feeding
Vomiting

Question 3

What are some signs of neonatal sepsis?

Answer 3

Respiratory distress or apnoea
Tachycardia or bradycardia
Jaundice within 24 hours (pathological jaundice)
Seizures
Hypoglycaemia

Question 4

Neonatal causes of jaundice can be split into what 2 main categories?

Answer 4

Increased production of bilirubin
Decreased clearance of bilirubin

Question 5

Some causes of increased bilirubin production?

Answer 5

Haemolytic disease of the newborn
Haemorrhage
ABO incompatibility

Question 6

Some causes of decreased bilirubin clearance?

Answer 6

Gilberts syndrome
Prematurity
Breast milk jaundice

Question 7

Breast milk jaundice usually occurs within the first week of life. True/false?

Answer 7

True

Question 8

How can you identify pathological jaundice?

Answer 8

Presents within the first 24 hours after birth and/or remains past day 14 of life.

Question 9

What are the ranges of prolonged jaundice?

Answer 9

Jaundice remaining:

After 14 days in a term baby.
After 21 days in a pre-term baby.

Question 10

What is kernicterus?

Answer 10

A type of brain damage caused by excess bilirubin levels hence why neonatal jaundice is treated in order to keep bilirubin below certain levels.

Question 11

What is haemolytic disease of the newborn?

Answer 11

A cause of haemolysis (breakdown of red blood cells) and jaundice of the neonate.

It is caused by incompatibility between the rhesus antigens on the surface of the red blood cells of the mother and the foetus.

Question 12

What is the most important rhesus antigen type within the rhesus blood group?

Answer 12

Rhesus antigen D

Question 13

What is hydrocephalus?

Answer 13

Cerebrospinal fluid (CSF) building up abnormally within the brain and spinal cord.

Question 14

Clinical presentation of hydrocephalus?

Answer 14

Enlarged and rapidly increasing head circumference
Poor feeding and vomiting
Sleepiness

Question 15

Necrotising enterocolitis primarily affects pre-term babies. True/false?

Answer 15

True, it is a disorder where part of the bowel becomes necrotic.

Question 16

Clinical presentation of necrotising enterocolitis?

Answer 16

Intolerance to feeds
Vomiting, particularly with green bile.
Generally unwell
Blood in stools
Absent bowel sounds

Question 17

What characteristic features are present on abdominal x-ray for necrotising enterocolitis?

Answer 17

Dilated loops of bowel
Bowel wall oedema
Gas in bowel wall

Question 18

What is the clinical presentation for jejunal atresia?

Answer 18

Neonates typically present with abdominal distension and bilious vomiting within 24 hours of birth.

Managed by surgical correction