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Paediatrics > Neonatology > Flashcards

Neonatology Flashcards

1
Q

When does the fetal heart start beating?

A

Beginning of 4th week

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2
Q

Through which vessel does the fetus receive oxygenated blood?

A

Umbilical vein

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3
Q

What is the ductus venosus in fetal circulation?

A

Ductus venosus allows oxygenated blood to pass directly from the umbilical vein into the IVC without having to travel through the liver

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4
Q

What two vessels are connected by the ductus arteriosus in the fetal circulation?

A

Aorta

Pulmonary artery

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5
Q

What is the normal O2 saturation in foetal circulation?

A

60-70%

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6
Q

What are the functions of the ductus arteriosus?

A

Protects lung against circulatory overload

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7
Q

What type of blood flows through the ductus arteriosus?

A

De-oxygenated blood

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8
Q

What type of blood flows through the ductus venosus?

A

Oxygenated blood

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9
Q

What happens to the ductus arteriosus and venosus following babies first breath after birth?

A

They get closed off and become ligaments

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10
Q

What is a normal BP for a newly born baby?

A

70/44

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11
Q

What is a normal respiratory rate for a new born baby?

A

30-60/min

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12
Q

What is a normal heart rate for a new born baby?

A

120-160 bpm

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13
Q

How do newborn babies generate heat?

A

Brown fat

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14
Q

What is the partial pressure for O2 and CO2 in the newborn?

A

PaO2 - 8-12

PaCO2 - 5-6

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15
Q

How long does physioloigcal jaundice normally last in the newborn?

A

2-10 days of life

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16
Q

In physiological jaundice, where does the majority of bilirubin come from?

A

Haemoglobin

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17
Q

Where is bilirubin metabolised and conjugated?

A

Liver

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18
Q

Is bilirubin water or lipid soluble?

A

Lipid soluble

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19
Q

What is the purpose of blue light treatment of babies who are jaundiced?

A

Blue light converts bilirubin to water soluble form and increases oxygenation of bilirubin

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20
Q

How much weight loss in the newborn baby is normal in the first few days?

A

Up to 10%

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21
Q

What causes the weight loss seen in babies in the first few days of life?

A

1 - Shift of interstitial fluid to intravascular

2 - Excessive urine production

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22
Q

What is normal amount of insensible water loss in babies?

A

20-40 ml/kg/day

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23
Q

Following birth, what happens to babies hameoglobin level?

A

Decreases

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24
Q

After 20 weeks of life, what happens to Hb level and why does it change?

A

Increases

Due to increased production of erythropoetin

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25
Q

What are the most common problems faced by babies in their first few days of life?

A

Abnormal skin colour

Hypoglycaemia

Hypothermia

Respiratory distress

Vomiting/reflux

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26
Q

What are the common skin problems encountered in neonates?

A

Jaundice

Pallor

Plethora

Cyanosis

Port wine stain

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27
Q

What are causes of jaundice in the neonate in first 24 hours of life?

A

G6PD

Torch

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28
Q

What some of the causes of jaundice within day 2 to 3rd week of life?

A

Physiological

Breast milk

Sepsis

Crigler-Najjar syndrome

29
Q

What can be a cause of jaundice after 3 weeks of life?

A

Hypothyroidism

30
Q

How is jaundice in the neonate investigated?

A

Bilirubinometer

FBC

Blood film

Coomb’s test

31
Q

How is jaundice in the neonate treated?

A

Phototherapy

Exchange transfusion

32
Q

In neonatal jaundice, what type of bilirubin builds up in the body?

A

Unconjugated bilirubin

33
Q

What is a complication of very high levels of bilirubin in the new born?

A

Kernicterus

34
Q

What is kernicterus?

A

A neurological condition caused by excessive levels of circulating bilirubin

35
Q

What are the clinical signs of acute kernicterus?

A
  • Reduced alertness
  • Reduced feeding
  • Hypertonia of extensor muscles
36
Q

What are the clinical signs of chronic kernicterus?

A

Hypotonia

Hyperreflexia

Delayed acquisition of motor milestones

Upward gaze

37
Q

Which babies are at risk of hypoglycaemia?

A

Premature babies

Infants of diabetic mothers

38
Q

What are some symptoms of hypoglycaemia?

A

Lethargy

Poor suck/feeding

Hypothermia

Vomiting

39
Q

In which ways can heat be lost by babies?

A

1 - Conduction

2 - Convection

3 - Evaporation

4 - Radiation

40
Q

If a child is cyanosed what is an important condition to think?

A

Sepsis

41
Q

What is Pierre Robin sequence?

A

Small jaw

Cleft palate

42
Q

Which bony processes fail to merge in cleft palate?

A

Maxillary process

Medial nasal process

43
Q

What are some common opthalmic problems in newly borns?

A

Cataracts

Retinoblastoma

44
Q

What is a common condition of the urinary system associated with neonates?

A

Renal pelvis dilatation

45
Q

What are some common problems associated with the male genitalia at birth?

A

1 - Undescended testes

2 - Micropenis

3 - Hypospadias

46
Q

What is a key difference between hydroceles and inguinal hernias?

A

Hydroceles cannot be reduced (squashed down)

Hernias can be reduced

47
Q

In the case of ambiguous genitalia, what investigations can be used to confirm the sex?

A

Chromosome analysis

USS to determine presence or absence of gonads

48
Q

What are some common problems of the neonatal skull following birth?

A

Cephalohaematomas

Caput succedaneum

49
Q

What are the most common nerve palsies found in neonates?

A

Brachial palsies

Facial palsies

50
Q

What is talipes?

A

Deviation of the foot

51
Q

What is developmental dysplasia of the hips?

A

When a shallow acetabulum causes the femur to slip out of the joint socket

52
Q

What tests can be used to diagnoses DDH?

A

Ortolani test

Barlow test

53
Q

What are the common features of Trisomy 21?

A

Hypotonia

Cardiac defects

Learning problems

Thyroid problems

54
Q

What are the common features of Edwards syndrome and what trisomy is this condition?

A

Trisomy 18

Small mouth, jaw and short neck

Clenched hands

Prominent occiput

55
Q

What are the common features of Patau syndrome and what trisomy is this?

A

Trisomy 13

Absent eyebrows

Cleft lip or palate

Clenched hands

Undescended testis

56
Q

What are the symptoms of a baby with sepsis?

A

Pyrexic or hypothermic

Poor feeding

Lethargy

57
Q

What is a risk factor for sepsis in neonates?

A

Premature rupture of membranes

58
Q

What initial measurements should be taken in suspected sepsis?

A

FBC

CRP

Blood cultures

59
Q

What are the 1st line antibiotics given in neonatal sepsis?

A

Penicillin

Gentamicin

60
Q

What are the most common organisms causing neonatal sepsis?

A

Group B strep

E.coli

Listeria

61
Q

What are the common congenital infections found in newborns?

A

TORCH

Toxoplasmosis

Rubella

CMV

Herpes

62
Q

What is meconium?

A

The earliest stool of an infant

63
Q

What is meconium aspiration?

A

When the baby inhales stool into its lungs

64
Q

What is a risk factor for meconium aspiration?

A

Post term babies

Maternal diabetes

Maternal hypertension

65
Q

What is an urgent cardiac condition in neonates?

A

Blue baby

66
Q

How is the ‘blue baby’ investigated?

A

CXR

Pulse oximetry

ECG

Echocardiogram

67
Q

What are some of the causes of a ‘blue baby’?

A

Tetralogy of Fallots

Tricuspid atresia

68
Q

How is the hypoglycaemic baby managed?

A

IV glucose

Increase fluids

Glucagon

Hydrocortisone

69
Q

What are some causes of failure to pass stool?

A

Constipation

Large bowel atresia

Hirschsprungs disease

Paediatrics (25 decks)

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