Neonatology

Question 1

Give the names and functions of the special shunts in fetal circulation

Answer 1

Ductus venosus; allowing blood to bypass the liver

Foramen ovale; lets blood flow straight from right to left side of the heart

Ducturs arteriosus; blood from pulmonary trunk is shunted into the descending aorta

Question 2

How does the lungs get rid of the amniotic fluid in them after birth?

Answer 2

Crying assists in the absorption into the lymphatic system

Question 3

What hormonal drop allows the closure of the ductus arteriosus?

Answer 3

Prostaglandins

Question 4

What is the ideal temperature of the newbron?

Answer 4

36.5-37.4ºC

Question 5

Why is fetal haemoglobin not advantageous in the neonate?

Answer 5

It holds onto oxygen and doesnt release it to the tissues so well. So once born increaes in 2,3 BPG that allows easier release of oxygen to tissues

Question 6

What conditions are screened for on the guthrie cards (heel prick test)

Answer 6

Cystic fibrosis
Haemoglobinopathies
Metabolic diseases (phenylketonuria, thyroid function, medium chain acyl-coa dehydrogenase deficiency, maple syrup urine disease, isovaleric acidaemia, glutaric aciduria type 1

Question 7

What are some of the conditions tested for in the newborns physical examination?

Answer 7

Hearing screening
Conenital dysplasia of hips
Caput succedeneum
Cephalhaematoma
Cataracts
Facial palsy
Tetralogy of fallot
Portwine stain

Question 8

What is the normal respiratory rate of the newborn?

Answer 8

40-60 permin

Question 9

What is the normal heart rate of the newbron?

Answer 9

120-140bpm

Question 10

What is the normal temperature of the newborn

Answer 10

36.5-37.4ºC

Question 11

What is the normal SP02 of the newborn?

Answer 11

> 95% like in adults

Question 12

What is the normal cap refil of the newborn?

Answer 12

2-3s

Question 13

How much mls of blood will a baby have per kg of weight?

Answer 13

80mls per kg

Question 14

What are the parameters of the apgar score

Answer 14

Appearance (colour)
Pulse (>100)
Grimace (cry and pull away)
Activity (flexed arms/legs)
Respiration (strong cry)

Question 15

Which groups of babies are more likely to have neonatal death?

Answer 15

<32wks
Twins
Multiple births
Black moms
Teenage moms
Those in poverty

Question 16

What are the conditions tested for in the guthrie cards? (Heel prick test)

Answer 16

Cystic fibrosis
Haemoglobinopathies
Metabolic disease (phenylketonuria, thyroid function, medium chian acyl coa dehydrogenase deficiency, maple syrup urine disease, isovaleric acidaemia, glutaric aciduria type 1, homocystinuria)

Question 17

Baby has a swelling in the outer layer of the skin what is it?

Answer 17

Caput succedeneum

Question 18

Baby has a swelling on his head that looks like horns. What is this likely to be?

Answer 18

Cephalhaematoma

Question 19

What gestation would a mom be given anti D in order to prevent rhesus disease

Answer 19

28wks and within 72hrs of birth

Question 20

Where is the injection site for anti-D in the mom

Answer 20

IM on deltoid muscle

Question 21

Why does respiratory distress syndrome occur?

Answer 21

Common in preterm infants <29wks

As surfactant not produced and has structural immaturity. Treat with prednisolone

Question 22

What is the most likley organism to cause infection in a neonate?

Answer 22

Group B strep (gram positive cocci)

Question 23

In a healthy neonate how many wet nappies should they produce?

Answer 23

6 or more wet nappies in 24hrs

3 dirty nappies in 24hrs

Question 24

How should breast milk be stored

Answer 24

Up to 6months at -18ºC
Coldest part of fridge for 5 days
Dont use microwave to warm or defrost

Question 25

What is haemorrhagic disease of the newborn caused by ?

Answer 25

As the neonate doesnt have the gut flora yet it cannot process vitamin K yet which is needed for clotting so they have a clotting disorder.

Question 26

What is the treatment for haemorrhagic disease of the newbron

Answer 26

Vitamin K IM