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good paeds > Neonatology > Flashcards

Neonatology Flashcards

1
Q

Grade 1-4 IVh

A

I: germinal matrix 35%
II: extension into lat ventricles <50% space
III: haemorrhage occupying at least 50%
IV: parenchyma involvement

(50% withinin 24h most by 3 days)

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2
Q

Indomethacin action

A

Cyclooxygenase 1 and 2 inhibitor - decreases prostaglandin synthesis from arachidonic acid

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3
Q

Ibuprofen action

A

Cyclooxygenase 2 inhibitor

Less profound s/e

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4
Q

Spontaneous closure what percent PDA

A

30-65%

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5
Q

Which zero type GBS more common in meningitis/late onset

A

Type 3

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6
Q

Colonisation rate GBS

A

5-40%

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7
Q

RBC lifespan prem and term

A

35-50 days

60-70

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8
Q

Bw under 1500g or <28w behaviour outcome

A

> 11x increase depression, 2.6x increase ADHD

Same quality of life

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9
Q

Do preterm babies have increased insulin resistance later in life

A

Yes

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10
Q

Late preterm risk CP

A

> 3x more cf term

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11
Q

Anomalies percent in gastroschisis and omphalocoele

A

10% gastroschisis and 60% omohalocoele

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12
Q

Survival in 23/40, 24, 25, 27, >30

A

23: 15%
24: 66%
25: 80%
27: 90-95%
30: 97-99%

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13
Q

Severe neurological disability ELBW

A

10-20%

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14
Q

Infant of diabetics mother at risk for

A

An infant of a diabetic mother is at risk for hypoglycemia, hypocalcemia,
polycythemia, and neonatal small left colon syndrome.

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15
Q

Soy formula term and preterm

Indications (2)

A

Term is as good as cows milk formula for growth
Not for preterm

The most appropriate indications for soy formula are in infants with
galactosemia and congenital lactase deficiency (extremely rare)

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16
Q

Me onion aspiration cxr finding

A

Coarse opacities and hyperexpansion

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17
Q

Corkscrew on axr diagnostic for

A

Midgut volvulus

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18
Q

Infantile spasms treatment

A

Vigabatrin

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19
Q

HIE in term cooling temperature

A

33 degrees

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20
Q

Sats target <28w

A

90-95%

After 32w need higher sats for better eyes

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21
Q

What percent of CP from birth asphyxia

A

10%

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22
Q

Severe disability and dev delay in 22-27w what percent

A

3.7%

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23
Q

Normal volume ventilation baby per breath

A

4-5ml/kg/breath

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24
Q

HFOV under ventilated and under oxygenated change what settings

A

To improve ventilation (increase amplitude and then decrease Hz) AF
To improve oxygenation (increase MAP)

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25
Q

IVH 3 and 4 outcome severe impairment

A

3: 40-50%
4: 60-90%

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26
Q

CAP trial showed

A

Decreased disability and CP and death

Improved PDA and CLD

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27
Q

NEC likely to present when

A

Week 2-3

Triad of bloody stool, distension, bile aspirate

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28
Q

Stages of ROP

A

1-5

4: some retinal detachment
5: complete retinal detachment

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29
Q

Post natal steroids given and why

A

> 7 days because improves CLD but increased risk ROP (but not blindness)
Very high risks if given sooner

30
Q

Delayed cord clamping other effects (apart from less blood transfusions)

A

Less IVH and NEC

31
Q

Difference in QOL prem vs term

A

Very little difference in quality of life preterm/VLBW vs term control

32
Q

IVF IUGR baby with high glucose and low insulin presenting in first 6 months

A 
Neonatal diabetes
Genetic links
Transient 50% (comes back in adolescence)
Permanent
(Insulin and oral sulphonuria)
33
Q

Bifid uvula genetic cause

A

Loews-Dietz syndrome

34
Q

Congenital scoliosis also assoc with two other organ abnormalities

A

Heart and GU

35
Q

Prem calories required

A

120kCal/kg/day

36
Q

Apt Test for maternal blood pink test goes what colour if adult Hb denatured?

A

Yellow indicating presence of maternal blood not fetal

37
Q

Kleihauer test is looking for

A

Quantitating fetal-maternal haemorrhage (differential resistance of fetal hb to acid)

38
Q

Fergus with flat nasal bridge, wide spaces eyes, digital hypoplasia and CV abnormalities associated with

A

Phenytoin exposure

Fetal hydatoin syndrome

39
Q

Most common type oesophageal atresia

A

Blind pouch with distal TOF

40
Q

What immunoglobulin in breast milk most protective

A

IgA

41
Q

Phenobarbitone is commonly used as the first line anticonvulsant in the treatment of neonatal
seizures. In what percentage of cases would you expect to achieve clinical control of seizures after a
loading dose of 20 mg/kg phenobarbitone?

A

40%

42
Q 
A six-month-old infant drinks 1000 ml of a standard cow milk formula daily. Approximately how much 
energy does the child get per day from his milk intake? 
A. 200 kcal (840 kJ) 
B. 500 kcal (2100 kJ) 
C. 670 kcal (2820 kJ) 
D. 810 kcal (3400 kJ) 
E. 1000 kcal (4200 kJ)
A

C

43
Q 
An infant is born at 26 weeks gestational with a birth weight of 750g. What are the expected insensible 
water losses (mls/kg/hour) on day one of life? 
A. 0.5 – 1.0. 
B. 2.0 – 3.0. 
C. 4.0 – 5.0. 
D. 8.0 –10.0. 
E. 12.0 – 15.0.
A

B

44
Q

Mother first episode herpes risk to child if vaginal birth?

A

35-50%

45
Q

If mother recurrent herpes then risk percent and plan?

A

3-5%

Cultures at 24-48h and then treat if symptoms or positive swab

46
Q

Weight gain per week 1-3m 3-6m 61-12m

A

0 to 3 months
150 -200g/week

3 to 6 months

100 - 150g/week

6 to 12 months

47
Q

Newborn serum creatinine reflects maternal in first ? Hours

A

48

48
Q

What is essential for growth

A

Sodium

49
Q

Hearing screen NZ and Aus uses

A

Automated auditory brainstem response (aABR)

Used to use automated otoacoustic emission (AOAE)

50
Q

Difference between bochdalek and morgagni hernias

A

Morgagni on right side cf bochdalek left

51
Q

Form of SCID with no hair and skin rash like eczema

A

Omenn syndrome

52
Q

Risk factor for group b strep

A

Prematurity (young mum)

53
Q

Antigen in neonatal alloimmune thrombocytopenia

A

Human platelet antigens (HPA-1a)

54
Q

Guthrie TSH cf plasma is

A

Half

55
Q

30% pier-robin sequence associated with what syndrome

A

Stickler

56
Q

CF males percent infertility

A

99% azoospermia

57
Q

Fetal Hb drops below 2% when

A

12m

Only trace 6-12m (10% at 6m)

58
Q

What happens to SVR at birth

A

Due to loss of tremendous blood flow through the placenta, the systemic vascular resistance at birth doubles.

59
Q

Which one of the following is the major cause of physiologic neonatal jaundice?
A. Decreased bilirubin uptake by the hepatocyte.
B. Decreased hepatic bilirubin conjugation.
C. Decreased hepatic excretion of bilirubin.
D. Increased de novo bilirubin synthesis.
E. Increased enterohepatic circulation

A

D

60
Q

Kleihaur and apt test described

A

HbF is resistant to alkali (Apt) and acids (Kleihauer) and so the HbA containing RBCs (maternal) will be hemolyzed but not the fetal RBCs as they contain the HbF.

61
Q

Calories in 100ml breast milk?

A

70

62
Q

Fetal haematopoeisis

A

Yolk sac from 2weeks – 2 months; liver 2-7 months; bone marrow starts at 3 months and
predominates from 7th month

63
Q

Indomethicin mode of action

A

Inhibits PG synthase

64
Q

Exposure to what causes broad low nasal bridge epicanthal folds, wide spaced eyes and CVD with digital hypoplasia

A

Fetal hydantoin syndrome from phenytoin

65
Q

ALPACA related to what brain abnormality

A

Holoprosencephaly

66
Q

Porencephalic cyst vs arachnoid cyst

A

Arachnoid on outside and surrounded by grey matter

Porencephalic is by ventricle inside

67
Q

Balanced Robertsonian translocation (carrier with normal phenotype) number of chromosomes total

A

45

68
Q

Kidney size per gestational week

A

Mm per week and complete by about 32-24 weeks

69
Q

Ear tags associated with?

A

Nager syndrome
Oculoauriculovertebral
Townes Brockw
4- and 5- deletion and 11q duplication

70
Q

Ear pits with?

A

Brachotorenal

BWS

good paeds (19 decks)

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