Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CH > Neonatology > Flashcards

Neonatology Flashcards

1
Q

Definition of preterm, v.preterm and extremely preterm

A

Preterm: 23-37wks
V.preterm: 23-32wks
Extremely preterm: 23-27wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the risk factors for preterm?

A 
>1baby
Problems with uterus or cervix
Maternal htn, diabetes, clotting disorders
Infections
Smoking, alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Normal HR and RR for babies <1yr

A

HR: 120-160
RR: 30-60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the use of cord clamping in premature baby management?

A

Cord clamping ok if baby is ok and can be kept warm.

Pause for at least 1 min to allow placental transfusion and use this time to assess baby.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the difference in resuscitation between term and preterm infants?

A

Term: should commence in air.

Preterm: a low conc of O2 (21-30%) should be used initially for resuscitation at birth. If in spite of effective ventilation oxygenation remains unacceptable higher O2 can be considered.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the sequence of actions in neonatal resuscitation?

A
  1. Keep baby warm and assess
  2. Airway
  3. Breathing
  4. Chest compressions
  5. Drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Action in neonatal resuscitation: Keep baby warm and assess?

A 
Delay in cord clamping if uncompromised
Maintain temp 36.5-37.5
APGAR
Reassess breathing and HR every 30s
HR key observation: if there is an improvement in baby, there will be an increase in HR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Action in neonatal resuscitation: Airway

A

Head in neutral position

Assess for obstruction with mucus, blood, meconium, vernix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Action in neonatal resuscitation: Breathing

A

Most babies have good HR after birth and establish breathing by 90s
If baby not breathing adequately, 5 inflation breaths
If HR increases, assume lungs aerated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Action in neonatal resuscitation: when should chest compressions commence?

A

If HR <60 or absent after 5 effective breaths or 30s of effective ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Action in neonatal resuscitation: Chest compressions

A

Two thumbs on lower end of sternum

Compression: inflation, 3:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which is low admission temp significant?

A

Independent risk factor for neonatal death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why is thermal regulation ineffective in the preterm baby?

A

Low BMR
Minimal muscular activity
Subcut fat insulation negligible
High ratio of S.A to body mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which 3 factors influence temp control in the neonate?

A

Hypothermia
Hypoxia
Hypoglycaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is gestational correction?

A

The age that the child would have been if the pregnancy was at term:

40weeks- no weeks gestation

e.g:
40-28wks=12wks-3months
Today aged 6months
corrected age: 6months-3months=

3 months corrected age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How long is corrected age used?

A

1year for infants born 32-36wks

2years for infants <32wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the time of onset in neonatal sepsis?

A

Early onset: due to bacterial spread acquired before and during delivery.

Late onset: acquired after delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are some of the causative organisms in neonatal sepsis?

A

GBS
Gram -ve (Ecoli, Klebsiella)
Gram +ve (Staph Aureus, Strep Pneumoniae)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How does early onset neonatal sepsis arise?

A
  • <48hrs after birth
  • Bacteria ascends birth canal + invades amniotic fluid
  • Baby secondarily infected as lungs are in direct contact with infected amniotic fluid
  • These babies have pneumonia/sepsis
  • Risk increased if PPROM, mother fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How does early onset neonatal sepsis present clinically?

A

Respiratory distress
Aponea
Temperature instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the investigations and management of early onset neonatal sepsis?

A
  • CXR and septic screen
  • Abx started prior to culture results
  • IV Abx to cover: GBS, listeria, gram -ve, gram +ve
  • If cultures and CRP -ve and baby clinically well, stop Abx after 48hrs.
  • If culture +ve or any neurological signs–> CSF exam and culture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does late onset neonatal infection arise?

A
  • > 48hrs after birth, baby’s environmental source
  • Nosocomial or NICU due to CVC
  • CoNS most common pathogen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the tx of late onset neonatal infection?

A
  • Initial Abx to cover Staph and gram-ve bacilli.

- Use of prolonged or broad spectrum Abx predisposes to invasive fungal infections in premature babies.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How does neonatal meningitis present?

A
  • Uncommon, high mortality
  • Bulging fontanelle
  • Hyperextension of head and back
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the risk factors of GBS infection?
- Prematurity - PPROM - Previous sibling with GBS infection - Maternal pyrexia (2ndry to chorioamnionitis)
26
What are the screening recommendations of GBS?
- Universal screening is NOT offered to all women. - Maternal request is NOT an indication. - Women who've had GBS in previous pregnancy have a 50% risk of GBS carriage in this pregnancy.
27
Who should be given Abx for GBS?
- Women with a previous GBS pregnancy should be offered maternal IV Abx prophylaxis OR late testing and if +ve Abx. - Maternal IV Abx prophylaxis given to all women in preterm labour regardless of GBS status. - Given to women with pyrexia in labour.
28
What is the Abx for GBS?
Benzylpenicillin
29
Is sticky eyes at 3-4 days normal?
Yes
30
Neonate with purulent discharge with conjunctival infection + swelling of eyelids within first 48hrs of life?
Gonococcal infection
31
What is the tx for gonococcal neonatal conjunctivitis?
Gram stain and culture discharge Permanent loss of vision can occur Penicillin resistance is a problem
32
Neonate with purulent discharge and swelling or eyelids at 1-2weks?
Chlamydia Trachomatis
33
What is the tx for Chlamydia Neonatal conjunctivitis?
Identify organism with immunofluorescent staining Tx with oral Erythromycin for 2wks Also check and tx mother and partner
34
Who should be offered screening for Hep B?
All mothers
35
What is the management for a baby who's mother is HBsAG +ve?
Should receive HepB vaccination shortly after birth
36
What is the management for a baby who's mother is 'e' antigen positive?
Should be given passive immunisation with HepB immunoglobulin within 24hrs birth
37
What are the clinical features of neonatal sepsis?
- Fever, temp instability or hypothermia - Poor feeding - Vomiting - Resp distress - Jaundice - Shock - Irritability - Lethargy
38
When is jaundice physiological and pathological in the newborn?
Pathological: <24hrs Physiological: 2-14days
39
In which babies is neonatal jaundice more common in?
Breast fed babies
40
If signs of jaundice after 14days, a jaundice screen should be performed. What is this?
``` Conjugated and unconjugated bilirubin Direct Coombs test TFTs FBC and blood film Urine for MC&S and decreased sugars U&Es and LFTs ```
41
What would a raised conjugated bilirubin indicate in a neonate >14days and what is the tx?
Biliary atresia | Surgical intervention required
42
What are some of the signs/symptoms in neonatal jaundice?
Yellow pigmentation Sleep and lethargic Poor feeding/weight gain (dehydration worsens jaundice) Pale stool + dark urine in conjugated
43
What is the tx for physiological jaundice?
Observe and reassurance
44
What is the tx of acute bilirubin encephalopathy?
Medical emergency | Immediate exchange transfusion
45
What are the signs of acute bilirubin encephalopathy?
``` Hypertonia Arching Retrocollis (backwards neck dystonia) Opisthotobos (muscle spasm, backwards arching) Fever High pitched cry ```
46
What is the process of an exchange transfusion in acute bilirubin encephalopathy?
Removes the unconjugated bilirubin by doing a double volume exchange transfusion to allow bilirubin to move out of the brain tissue and decrease the risk of neurological toxicities. +phototherapy, +hydration
47
How does phototherapy work for neonatal jaundice?
By blue band of light spectrum converting unconjugated bilirubin into water soluble pigment therefore more readily excreted and does not require coagulation
48
What is the tx of: pathological unconjugated and conjugated neonatal jaundice?
Unconjugated: phototherapy or exchange transfusion Conjugated: tx of underlying cause
49
What is the tx of breast milk jaundice?
1st line: temporary cessation of breast-feeding for 24-24hrs 2nd line: phototherapy + hydration 3rd line: exchange transfusion
50
What is Kernicterus?
Complication of jaundice | Due to accumulation of unconjugated bilirubin in basal ganglia
51
What does Kernicterus lead to?
``` Choreoathetoid CP (dyskinetic) Sensorineural hearing loss ```
52
What are some of the causes of neonatal jaundice <24hrs?
Haemolytic disorders: - Rh incompatibility - ABO incompatibility - G6PD deficiency
53
What are some of the causes of neonatal jaundice 24hrs-2weeks?
- Physiological - Breast milk jaundice - Infection (UTI) - Haemolysis - Polycythaemia - Crigler-Najjar Syndrome
54
What are some of the causes of unconjugated neonatal jaundice >2weeks?
- Physiological or breast milk - Infection (UTI) - Hypothyroidism - Haemolytic anaemia - High obstruction: pyloric stenosis
55
What are some of the causes of conjugated neonatal jaundice >2weeks?
Bile duct obstruction | Neonatal hepatitis
56
If jaundice is present >2weks, what is it important to diagnose?
Biliary atresia
57
How does neonatal hypoglycaemia present?
``` <24hrs life In babies with IUGR who are preterm, born to mothers: -T2DM -Large for dates pregnancy -Hypothermia -Polycythaemia ```
58
What glucose level is desirable for optimal neurodevelopment outcome in neonates?
>2.6mmol/l
59
How can neonatal hypoglycaemia be prevented an treated?
Prevented: early and frequent milk feeding Tx: IV Glucose
60
What needs to be ruled out when neonatal seizures are observed?
- Hypoglycaemia and meningitis | - Cerebral US to identify haemorrhage
61
What are some of the causes of neonatal seizures?
``` HIE Cerebral infarction Metabolic (hypoglycaemia) Intracranial haemorrhage Cerebral malformations Dx withdrawal (maternal opiates) Congenital infection Kernicterus ```

CH (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions