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Paedriatrics > Neonatology > Flashcards

Neonatology Flashcards

1
Q

Why might newborn infants need special medical care?

A 
Prematurity
Low birth weight
Intrauterine growth restriction
Congenital malformations
Infection
Birth asphyxia
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2
Q

When does the development of the CVS begin embryological?

A

3rd week

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3
Q

When does the heart start to beat?

A

Beginning 4th week

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4
Q

When is the critical period of heart development after fertilization?

A

Day 20-50

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5
Q

How does the foetus receive oxygenated blood?

A

Umbilical vein (ductus venosus)

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6
Q

What is the purpose of the ductus arteriosius?

A

Protects lungs against circulatory overload
Allows the right ventricle to strengthen
Carries low oxygen saturation blood

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7
Q

What is the ductus venosus?

A

Foetal blood vessel connecting the umbilical vein to the IVC

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8
Q

What type of blood does the ductus venosus usually carry?

A

Oxygenated blood

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9
Q

What happens to the ductus arteriosus and venosus during the first breath?

A

Becomes ligaments

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10
Q

What happens to the foramen ovale during the first breath?

A

Closes and leaves a depression

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11
Q

What happens to the umbilical vein and arteries during first breath?

A

Become ligaments

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12
Q

What is the normal BP at 1 hr age?

A

70/44

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13
Q

What is the normal BP 3 days after birth?

A

77 +/- 12

49 +/- 10

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14
Q

What is the usual RR in a full term newborn?

A

30-60/min

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15
Q

What is the normal HR in a full term newborn?

A

120-160bpm

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16
Q

What is tachycardia in a full term newborn?

A

> 160

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17
Q

What is a bradycardia in a full term newborn?

A

<100

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18
Q

What do newborns have to help with thermoregulation?

A

Brown fat

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19
Q

What is brown fat innervated by?

A

Sympathetic neurons

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20
Q

What can cold stress lead to in newborns?

A

Lipolysis

Heat production

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21
Q

What do newborns lack in terms of thermoregulation?

A

Shivering

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22
Q

What are the ways in which heat is lost?

A

Radiation
Convection
Evaporation
Conduction

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23
Q

What are non—invasive techniques to check a newborns breathing?

A

Blood gas
PaCO2 5-6kPa
PaO2 8-12kPa
Transcutaneous pCO2/O2 measurement

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24
Q

What are invasive techniques to check a newborns breathing?

A

Capnography
Tidal volume
Minute ventilation
Flow-volume loop

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25
Q

When does physiological jaundice occur?

A

DOL 2-3

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26
Q

What does DOL stand for?

A

Day of life

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27
Q

When does physiological jaundice disappear?

A

DOL 7-10 in term infants

DOL 21 premature infants

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28
Q

How is physiological jaundice caused?

A

In newborns, jaundice tends to develop because of two factors—the breakdown of fetal hemoglobin as it is replaced with adult hemoglobin and the relatively immature metabolic pathways of the liver, which are unable to conjugate and so excrete bilirubin as quickly as an adult

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29
Q

What is a complication of physiological jaundice in newborns?

A

Kernicterus

30
Q

What is kernicterus?

A

Bilirubin-induced brain dysfunction

31
Q

What are treatments for severe jaundice in newborns?

A

Exchange transfusion

Phototherapy

32
Q

Why is there weight loss in a newborn infant?

A

Shift of interstitial fluid to intravascular

Diuresis

33
Q

Is it normal for a newborn to not pass urine for the first 24 hours?

A

Yes

34
Q

Why is there increased loss through the kidney?

A

Slower GFR
Reduced Na reabsorption
Decreased ability to concentrate or dilute urine

35
Q

How is there increased Insensible Water Loss (IWL)?

A

Via immature skin and breathing

36
Q

On DOL 7 what is the RBC production compared to what it was in uterus?

A

10% of in uterus

37
Q

What is the Hb at birth?

A

15-20g/l

38
Q

What is the Hb at week 10?

A

11.4g/l

39
Q

Why is there anaemia of prematurity?

A

Reduced erythropoesis
Infection
Blood letting

40
Q

What are symptoms of anaemia in a newborn?

A

Pale skin
Sluggish
Poor feeding or tired when feeding
Fast HR and rapid breathing when resting

41
Q

What does SGA stand for?

A

Small for gestational age (SGA)

42
Q

What does IUGR stand for?

A

Intra-uterine growth restriction (IUGR)

43
Q

What are causes for small for date?

A

Maternal
Foetal
Placental
Other - twin pregnancy

44
Q

What is an example of a maternal cause for small for date?

A

Maternal pre-eclamptic toxemia (PET)

45
Q

What are foetal causes of small for date?

A 
Chromosomal (Edwards syndrome)
Foetal infection (CMV)
46
Q

What are some common problems in small for dates?

A 
Perinatal hypoxia
Hypoglycaemia
Hypothermia
Polycythaemia
Thrombocytopenia
GI problems
47
Q

What are potential long term problems for small for dates?

A

Hypertension
Reduced growth
Obesity
Ischaemic heart disease

48
Q

What is a preterm baby?

A

<37wks

49
Q

What is an extremely preterm baby?

A

<28wks

50
Q

What is a low birth weight?

A

<2500g

51
Q

What is a very low birth weight?

A

<1500g

52
Q

What is an extremely low birth weight?

A

<1000g

53
Q

What is RDS?

A

Respiratory distress syndrome

54
Q

What is IVH?

A

Intra-ventricular haemorrhage

55
Q

What is PVL?

A

Peri-ventricular leucomalacia

56
Q

What is NEC?

A

Necrotising enetro-colitis

57
Q

What is PDA?

A

Persistant ductus arteriosus

58
Q

What is BPD?

A

Broncho-pulmonary displasia

59
Q

What is ROP?

A

Retinopathy of prematurity

60
Q

What is PHH?

A

Post-haemorrhagic hydrocephalus

61
Q

What is NAS?

A

Neonatal abstinence syndrome

62
Q

What is HIE?

A

Hypoxic-ischaemic encephalopathy

63
Q

What is the prevention for RDS?

A

Antenatal steroids

64
Q

What is the early treatment for RDS?

A

Surfactant
Early extubation
Non-invasive support (N-CPAP)
Minimal ventiliation

65
Q

What can be used as a respiratory stimulant in newborns?

A

Caffeine

66
Q

What is the prevention for IVH (Intra-ventricular haemorrhage) of the brain?

A

AN steroids

67
Q

What causes PDA (Persistant ductus arteriosus) in a newborn?

A

Pressure Ao>PA = L->R shunt

68
Q

What happens as a result of L->R shunt in PDA?

A

Over-perfusion of lungs
Lung edema
Systemic ischaemia

69
Q

What are the consequences of PDA?

A

Worsening of resp symptoms
Retention of fluids (renal problems)
GI problems

70
Q

What happens in NEC (necrotising entero-colitis)?

A

Ischaemic and inflammatory changes

Necrosis of bowel

71
Q

What is the management of NEC?

A

Surgical intervention

Conservative? - antibiotics and parenteral nutrition

Paedriatrics (19 decks)

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