Neonatology Flashcards

1
Q

Define preterm

A

Birth at less than 37 weeks gestation

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2
Q

How many weeks gestation is post-term? And what is the management of this?

A

> 42 weeks

IOL

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3
Q

Define low birth weight

A

Birth wt <2.5kg regardless of gestation

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4
Q

Define large birth weight

A

> 4.0kg

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5
Q

How many weeks gestation is extremely preterm?

A

23 - 27+6

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6
Q

How many weeks gestation is very preterm?

A

28 - 31+6

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7
Q

What is the risk in meconium aspiration?

A

Neonatal sepsis

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8
Q

What are the benefits of skin: skin contact?

A

Prevents hypothermia and increases breastfeeding success

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9
Q

What is the name of the condition that occurs when fetal lung fluid is retained?

A

Transient tachypnoea of the newborn

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10
Q

What is the Mx of transient tachypnoea of the newborn?

A

Resolves over 24hr

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11
Q

Why are premature babies at risk of hypoglycaemia?

A

Less glycogen stores

Surface area : body ratio

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12
Q

Vitamin K deficiency can cause what neonatal condition?

A

Haemorrhagic disease of the newborn

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13
Q

“Epicanthal folds, small eye openings, flat midface, upturned short nose, no philtrum, thin upper lip, low nasal bridge, minor ear anomalies, short palpebral fissures” is the presentation of what condition?

A

Fetal alcohol syndrome

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14
Q

What neonatal condition occurs when fetal circulation persists, causing a L>R shunt?

A

Persistent pulmonary HTN of newborn

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15
Q

“Thick RV, pulmonary stenosis, VSD, aorta connected to both ventricles” describes what condition?

A

Tetralogy of Fallot

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16
Q

“Abdominal contents (bowel) in thoracic cavity” describes what condition?

A

Diaphragmatic hernia

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17
Q

What is Potter’s syndrome

A

Bilateral renal agenesis; causing oligohydramnio (no amniotic fluid)

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18
Q

What is microcephaly?

A

Small head circumference

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19
Q

What condition is being described?

  • Severe abdo swelling
  • Swollen liver
  • Aetiology is rhesus disease or chromosomal
A

Hydrops fetalis

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20
Q

How does jejunal atresia present?

A

Bile stained vomit, initially keen to feed, abdo distends with time

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21
Q

What is seen on AXR in jejunal atresia?

A

Very distended prox bowel

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22
Q

What is the management of jejunal atresia?

A

Surgical

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23
Q

An absent groin crease in a neonatal male is suspicious of?

A

Hernia

Scrotum also asymmetric

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24
Q

What is the management of neonatal hernia?

A

Surgical

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25
How does meconium ileus present?
Big doughy abdo, vomiting, meconium delay
26
What condition is meconium ileus associated with?
CF
27
What is seen on AXR with lower GI contrast in meconium ileus?
Soap sign | Small bowel distended with meconium (contrast doesn’t get that far)
28
What is the management of meconium ileus?
Surgical
29
How does malrotation present?
Green vomiting
30
What is seen on AXR with upper GI contrast in malrotation?
Low duodenal flexure + high caecum | Due to twisted bowel
31
What is the management of malrotation?
Surgical
32
What is the mechanism in necrotizing enterocolitis?
Prem baby with immature bowel given milk, perforation, bowel wall infection
33
What is seen on AXR in necrotizing enterocolitis NEC?
Mottled appearance
34
What is the Mx of NEC?
Surgical
35
Is low or high BMI of the mother a RF for preterm labour?
Low
36
What is the commonest cause of preterm labour?
Spontaneous
37
What is percentage of preterm births are planned C-sections?
25%
38
Is metabolic rate higher or lower than normal in a preterm baby?
Lower
39
Should breastfeeding be done in very preterm babies?
No, collect mum's expression and freeze it for later
40
Pre and postal ductal saturations are measured in preterm babies to check for what condition?
Patent ductus arteriosus
41
Which bacteria are the commonest cause of early onset neonatal sepsis (when the bacteria is acquired during delivery)
GBS group B strep and gram -ves
42
Which bacteria are the commonest cause of late onset neonatal sepsis (when the bacteria is acquired post delivery)
Coag -ve staph, gram -ve, s. aureus
43
What is the pathology between respiratory distress syndrome?
Surfactant deficient
44
How does RDS present?
Tachypnoea, grunt, intercostal recession, nasal flaring, cyanosis, worsens
45
What is seen on CXR in RDS?
Ground glass appearance
46
What is the Mx of RDS?
CCS, ventilate
47
What is a normal birth weight?
2.5 - 4 kg
48
When is the neonatal period?
0 - 28 days
49
What colour is normal meconium?
Black
50
When should meconium normally occur
1st 24 hours
51
What is a normal HR of the newborn?
120 - 140
52
What is a normal RR of the newborn?
40 - 60
53
What does the ductus arteriosus become?
Ligamentum arteriosus
54
What does the ductus venosus become?
Ligamentum teres
55
Shortly following birth, what causes alveolar expansion in the newborn's lungs?
Their 1st breath
56
What effect does the newborn taking its first breath have on pulmonary and systemic vascular resistance?
Pulmonary resistance drops | Systemic resistance raises
57
What circulating substance contributes to the closure of the foramen ovale?
Prostaglandins
58
Can babies shiver?
No
59
How do newborns produce heat?
Non shivering homeostasis Catecholamines brown fat breakdown Peripheral vasoconstriction
60
_____ homeostasis is maintained in the newborn by metabolising glycogen stores for _____
GLUCOSE homeostasis is maintained in the newborn by metabolising glycogen stores for GLUCONEOGENESIS
61
What is the name of the first milk produced?
Colostrum
62
What reflex is involved in milk expulsion?
Milk let down reflex | Also sucking and root reflexes in the neonate
63
What are foremilk and hindmilk composed of?
Foremilk protein | Hindmilk fat
64
In newborns, the increased 2,3DPG shifts the oxygen dissociation curve in what direction?
Right
65
Is physiological jaundice conjugated or unconjugated bilirubin?
Unconjugated
66
What is the function of Apgar scores?
Measure perinatal adaptation
67
What is a normal and a maximum Apgar score?
Normal >8 | Maximum 10
68
What are the 5 domains in Apgar scoring?
``` Colour HR RR Tone Grimace reflex irritability ```
69
What are the options for colour in Apgar scores?
0 blue/pale 1 extremities blue/body pink 2 no cyanosis
70
What are the options for RR in Apgar scores?
0 none 1 weak / irregular / gasp 2 good cry
71
What are the options for HR in Apgar scores?
0 absent 1 <100 2 >100
72
What are the options for tone in Apgar scores?
0 none 1 some flexion 2 flexed + resist extension
73
What are the options for grimace reflex irritability in Apgar scores?
0 no response 1 grimace / weak cry 2 cry / pull away / cough / sneeze
74
What is the rooting reflex?
Turn face and suck when stroke lip/cheek
75
What is the Moro reflex?
When the baby feels like its falling, it spreads its arms and cries
76
How are metabolic diseases screen for in newborns?
Heal prick blood test
77
What forms of screening do newborns receive?
Heal prick blood test Newborn examination Hearing test US hip