Neonatology Flashcards
When does the CVS begin to develop?
The end of the third week of gestation
When does the heart begin to beat ?
Fourth week of gestation
When is the critical development of heart development?
Day 20-50 after fertilisation
What provides oxygenated blood to a fetus?
Umbilical vein
How does blood get to the aorta in a fetus?
Foramen ovale –> left atrium –> left ventricle –> aorta
Where foes blood travel to from the right ventricle?
Pulmonary artery to the patent ductus arteriosus to aorta
What is the function of the ductus arteriosus?
Protects lungs against circulatory overload
Allows RV to strengthen
Carries low oxygen saturated blood
What is the function of the ductus venosus?
Foetal blood vessel connecting the umbilical vein to the IVC
Blood flow is regulated by a sphincter and carries mostly oxygenated blood
What is the normal RR for a neonate?
30-60 resps/min
What is the normal HR for a neonate ?
120-160 bpm
What is the normal blood pressure for a 1 hour old baby?
70/44
What is the blood pressure for a one day old?
~70/42
What is the blood pressure for a three day old baby?
~77/49
What kind of fat insulates babies?
Brown fat
- cold fat leads to lipolysis and heat production
Define radiation?
Heat dissipated to colder objects
Define convection?
Heat loss by moving air
Define conduction?
Heat loss to surface on which baby lies
What is physiological jaundice?
Jaundice that appears on day of life and dissapears within 7-10 days in term infants/21 days in premature infants
Can be prolonged till 30 days if baby is experiencing breast fed jaundice
How can jaundice be treated?
Biliblanket
Phototherapy
What are Milia?
white papules on nose caused by hyerplastic sebaceous glands
What are miliaria?
Immature sweat glands
What are the causes of jaundice in children?
24 hours old = Haemolytic anaemia, TORCH
2nd day - 3rd week
- physiological
- breast milk
- sepsis
- polycythaemia
- cephalhaematoma
- craiger-najar syndrome
- haemolytic disorders
3rd week onwards
- breast milk
- hypothyroidism
- pyloric stenosis
- cholestasis
What are the symptoms of hypoglycaemia in neonates?
Jitteriness, hypothermia, temperature instability, lethargy, hypotonia, apnoea, poor suck, vomiting, high pitched or weak cry, seizures
Define hypoglycaemia?
Blood sugar <2.6mmol/l
How is heat lost ?
Conduction
Convection
Evaporation
Radiation
How does one resuscitate baby under cold stress?
Dry quickly Remove wet linnens Use warm towels/blankets Provide radiant warmer heat Use heated/humidified oxygen
Tongue Ties are characterised by
?
Short +/- thickened frenulum
Attached anteriorly to base of tongue
What areas are assessed for retractions if baby is admitted to NNU?
Substernal
Subcostal
Intercostal
Supreasternal
What are the main symptoms of airway obstruction?
Stridor and retractions
What are the causes of airway obstruciton?
Laryngomalacia - worse at 2-4 months, gets better without treatment
Tracheomalacia - improves by 2 years old
Bronchomalacia - need CPAP +/- tracheostomy
What should be considered immediately if cyanosis is present?
SEPSIS
What may spinal dimples indicate?
Spina bifida
Kidney problems
When should spinal dimples be investigated?
If dimple is
- Large
- Red
- Swollen
- Pigmented
- Tender
- accompanied by fluid
