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Paediatrics > Neonatology > Flashcards

Neonatology Flashcards

1
Q

What is the normal blood pressure of a new-born?

A

1 hour old

  • Systolic 70
  • Diastolic 44
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2
Q

What is the usual respiratory rate of a new-born?

A
  • 30-60 per minute
  • Periodical breathing pattern
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3
Q

What is considered normal HR in a new-born?

A
  • 120-160bpm
  • tachycardia = >160bpm
  • bradycardia = <100bpm
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4
Q

Why do new-borns need metabolic production of heat?

A

They lack shivering thermogenesis

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5
Q

When does physiological jaundice occur?

A
  • Appears on Day of life (DOL) 2-3.
  • Disappears within 7-10 DOL in term infants and up to 21 DOL in premature infants.
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6
Q

What is the incidence of physiological jaundice?

A

Up to 60% of term babies and 80% of premature babies

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7
Q

When is it normal not to pass urine?

A

Term baby for the first 24 hours

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8
Q

Why do premature infants lose more water through their kidneys?

A
  • Slower GFR
  • Reduced Na reabsorption
  • Decreased ability to concentrate or dilute urine
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9
Q

What is considered IUGR?

A

<10th centile

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10
Q

What is considered severe IUGR?

A

<0.4th centile

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11
Q

What are the categories of causes of babies being small for dates?

A
  • Maternal
  • Foetal
  • Placental
  • Other
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12
Q

What maternal causes of small for dates are there?

A
  • Alcohol
  • Smoking
  • Pre-eclamptic toxaemia
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13
Q

What foetal causes of small for dates are there?

A
  • Chromosomal (Edwards’ syndrome)
  • Infection (CMV)
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14
Q

What placental causes of small for date are there?

A
  • Placental abruption
  • Anything that affects placental perfusion
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15
Q

Why can small for dates occur with twins?

A

Twin to twin transfusion syndrome

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16
Q

What are some common problems experienced by small for date babies?

A
  • Perinatal Hypoxia
  • Hypoglycaemia
  • Hypothermia
  • Polycythaemia
  • Thrombocytopenia
  • Gastrointestinal problems (feeds, NEC)
  • RDS, Infection
17
Q

What long term problems can babies that are small for dates experience?

A
  • Hypertension
  • Reduced growth
  • Obesity
  • Ischaemic heart disease
18
Q

Premature

A

Baby delivered <37 weeks

19
Q

Extremely preterm

A

Baby delivered <28 weeks

20
Q

Low birth weight

A
  • Low birth weight = <2500g
  • Very low birth weight = <1500g
  • Extremely low birth weight = <1000g
21
Q

How is RDS (respiratory distress syndrome) prevented?

A

Antenatal steroids

22
Q

What early treatment is there for RDS?

A
  • Surfactant
  • Early extubation
  • N-CPAP
  • Minimal ventilation
23
Q

What can cause BPD (Bronchopulmonary dysplasia)?

A

Damage to the lungs casued by mechanical ventillation and long term use of oxygen

24
Q

How is BPD (Bronchopulmonary dysplasia) treated?

A
  • Patience
  • Nutrition and growth
  • Steroids
25
Q

What minor respiratory problems can premature babies face?

A
  • Apnoea
  • Irregular breathing
  • Desaturations
26
Q

How can minor respiratory problems be managed in premature babies?

A
  • Caffeine
  • N-CPAP
27
Q

How can IVH (Inter-ventricular haemorrhage) be prevented?

A

Antenatal steroids

28
Q

How can IVH (Inter-ventricular haemorrhage) be treated?

A
  • Symptomatic
  • Drainage
29
Q

What is the pathophysiology of PDA (Patent ductus arteriosus)?

A
  • Pressure of aorta > pulmonary artery leading to LR shunt
  • Additional blood to pulmonary circulation leads to over-perfusion of lungs and lung oedema
  • Steal from systemic circulation leads to systemic ischaemia
30
Q

What are the consequences of PDA (Patent ductus arteriosus)?

A
  • Worsening of respiratory symptoms
  • Retention of fluids (poor renal perfusion)
  • GI problems (ischaemia)
31
Q

What is NEC (Necrotising entero-colitis)?

A

Ischaemic and inflammatory changes leading to necrosis of the bowel

32
Q

How is NEC (Necrotising entero-colitis) managed?

A
  • Surgical intervention is often required
  • Conservative management is sometimes possible by antibiotics and parenteral nutrition
33
Q

What are the outcomes of extreme prematurity?

A
  • I/3 die
  • 1/3 have normal life/mild disability
  • 1/3 have moderate/severe disability

Paediatrics (38 decks)

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