Neonatology Flashcards
Calories in breast milk
67kcal/ 100ml
Time to introduce solids
after 17wks
no later than 26 wks
Whole pasteurised cow’s milk
from 1 year
full fat until 5 yrs
How does phototherapy work
converts unconjugated bilirubin into harmless water soluble pigment
excreted in urine
Late onset (>48 hrs) infection cause
staphylococcus epidermidis
Late onset neonatal infection management
flucloxacillin and gentamicin
Rubella infection features
sensori neural deafness
cong. cataracts
cong. heart disease (PDA)
glaucoma
Taxoplasmosis features
congenital calcification
chorioretinitis
hondrocephalus
Cytomegalovirus features
growth retardation
purpuric skin lesion
Define caput succedaneum
beyond the margins of the sutures
resolves within few days
Cephalheamatoma
bleeding within the periosteum
confined within suture margins
resolves over few weeks
Newborn screening
Cystic fibrosis Congenital hypothyroidism Haemoglobinopathies 6 inborn errors of metabolism -Phenalketouria, PKU -Medium chain anyl-CoA dehydrogenase deficiency, MCAD -Glutaric acuduria type 1, GA1 -Isovaleric academia -Homocystinuria -Maple syrup disease
When is newborn blood spot screening performed
day 5-7
Phenylketouria
learning difficulties
seizures
microcephaly
MCAD: Medium chain acetyl-CoA dehydrogenase deficiency
rapidly progressive encephalopathy
collapse after prolonger fast
-> non-ketotic hypoglycaemia
Glutaric acuduria type 1
macrocephaly w/ encelopathic crisis at 6-18 m
-> dystonic-dyskinetic movement disorder
Isovaleric academia
metabolic acadaemia +/- hyperammonaemia
Homocystinuria
marfanoid appearance learning difficulties lens dislocation osteoporosis thromboembolism
Maple syrup urine disease
progressive encephalopathy
Prematurity definition
<37 wks
very preterm define
28 to 32 wks
extremely preterm define
<28 wks
management of apnoea, bradycardia and desaturations in premature babies
caffeine
CPAP
Neonatal respiratory distress syndrome cause and pathophysiology
surfactant deficiency
reduced surface tension
widespread alveolar collapse
inadequate gas exhange
Neonatal RDS prophylaxis
antenatal glucocorticoids
stimulate surfactant production
Neonatal RDS clinical features
at delivery or within 48hrs tachypnoea >60 chest wall recessions nasal flaring expiratory grunting (creates positive airway pressure) cyanosis
Neonatal RDS CXR finidings
diffuse frantumar or ground glass appearance
air bronchograms
indistinct heart boarder
Preterm brain injury pathophysiology
periventricular and intraventricular haemorrhages are common in preterm babies
ischaemia with re-perfusion injury
free radical injury
-> increased arterial flow (hypoxia, hypercapnia, HTN)
-> reduced venous flow (heart failure)
=> increased gradient across the wall of capilaries
—> vessel rupture
Define periventricular leukomalacia, PVL
white matter brain injury following heamorrhage
- > flare on USS
- > risk of spastic diplegia
Which babies are screened for retinopathy?
<1500g birthweight
<32 wks gestation
-> weekly ophthalmology review
Necrotising enterocolitis
bacterial invasion of ischaemic bowel wall
Necrotising enterocolitis clinical features
feeds not tolerated milk aspirated from stomach vomiting distented abdo \+/- fresh blood in stools
Necrotising enterocolitis Xray
dilated bowel loops
thumb printing
transmural gas
+/- gas in portal tract and pneumoperitoneum
Necrotising enterocolitis Rx
parental nutrition
broad spec abx
repair perforations
