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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
What are the most common problems faced by babies in their first few days of life?
Abnormal skin colour Hypoglycaemia Hypothermia Respiratory distress Vomiting/reflux
26
What are the common skin problems encountered in neonates?
Jaundice Pallor Plethora Cyanosis Port wine stain
27
What are causes of jaundice in the neonate in first 24 hours of life?
G6PD Torch
28
What some of the causes of jaundice within day 2 to 3rd week of life?
Physiological Breast milk Sepsis Crigler-Najjar syndrome
29
What can be a cause of jaundice after 3 weeks of life?
Hypothyroidism
30
How is jaundice in the neonate investigated?
Bilirubinometer FBC Blood film Coomb's test
31
How is jaundice in the neonate treated?
Phototherapy Exchange transfusion
32
In neonatal jaundice, what type of bilirubin builds up in the body?
Unconjugated bilirubin
33
What is a complication of very high levels of bilirubin in the new born?
Kernicterus
34
What is kernicterus?
A neurological condition caused by excessive levels of circulating bilirubin
35
What are the clinical signs of acute kernicterus?
- Reduced alertness - Reduced feeding - Hypertonia of extensor muscles
36
What are the clinical signs of chronic kernicterus?
Hypotonia Hyperreflexia Delayed acquisition of motor milestones Upward gaze
37
Which babies are at risk of hypoglycaemia?
Premature babies Infants of diabetic mothers
38
What are some symptoms of hypoglycaemia?
Lethargy Poor suck/feeding Hypothermia Vomiting
39
In which ways can heat be lost by babies?
1 - Conduction 2 - Convection 3 - Evaporation 4 - Radiation
40
If a child is cyanosed what is an important condition to think?
Sepsis
41
What is Pierre Robin sequence?
Small jaw Cleft palate
42
Which bony processes fail to merge in cleft palate?
Maxillary process Medial nasal process
43
What are some common opthalmic problems in newly borns?
Cataracts Retinoblastoma
44
What is a common condition of the urinary system associated with neonates?
Renal pelvis dilatation
45
What are some common problems associated with the male genitalia at birth?
1 - Undescended testes 2 - Micropenis 3 - Hypospadias
46
What is a key difference between hydroceles and inguinal hernias?
Hydroceles cannot be reduced (squashed down) Hernias can be reduced
47
In the case of ambiguous genitalia, what investigations can be used to confirm the sex?
Chromosome analysis USS to determine presence or absence of gonads
48
What are some common problems of the neonatal skull following birth?
Cephalohaematomas Caput succedaneum
49
What are the most common nerve palsies found in neonates?
Brachial palsies Facial palsies
50
What is talipes?
Deviation of the foot
51
What is developmental dysplasia of the hips?
When a shallow acetabulum causes the femur to slip out of the joint socket
52
What tests can be used to diagnoses DDH?
Ortolani test Barlow test
53
What are the common features of Trisomy 21?
Hypotonia Cardiac defects Learning problems Thyroid problems
54
What are the common features of Edwards syndrome and what trisomy is this condition?
Trisomy 18 Small mouth, jaw and short neck Clenched hands Prominent occiput
55
What are the common features of Patau syndrome and what trisomy is this?
Trisomy 13 Absent eyebrows Cleft lip or palate Clenched hands Undescended testis
56
What are the symptoms of a baby with sepsis?
Pyrexic or hypothermic Poor feeding Lethargy
57
What is a risk factor for sepsis in neonates?
Premature rupture of membranes
58
What initial measurements should be taken in suspected sepsis?
FBC CRP Blood cultures
59
What are the 1st line antibiotics given in neonatal sepsis?
Penicillin Gentamicin
60
What are the most common organisms causing neonatal sepsis?
Group B strep E.coli Listeria
61
What are the common congenital infections found in newborns?
TORCH Toxoplasmosis Rubella CMV Herpes
62
What is meconium?
The earliest stool of an infant
63
What is meconium aspiration?
When the baby inhales stool into its lungs
64
What is a risk factor for meconium aspiration?
Post term babies Maternal diabetes Maternal hypertension
65
What is an urgent cardiac condition in neonates?
Blue baby
66
How is the 'blue baby' investigated?
CXR Pulse oximetry ECG Echocardiogram
67
What are some of the causes of a 'blue baby'?
Tetralogy of Fallots Tricuspid atresia
68
How is the hypoglycaemic baby managed?
IV glucose Increase fluids Glucagon Hydrocortisone
69
What are some causes of failure to pass stool?
Constipation Large bowel atresia Hirschsprungs disease

Paediatrics (25 decks)

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