Neonatology

Question 1

Physiological jaundice in newborns?

Answer 1

2nd day to 3rd week
Red cell breakdown
Immature liver enzymes
Unconjugated hyperbilirubinemia

Question 2

Jaundice within 24hrs?

Answer 2

Always pathological
TORCH
G6PD deficiency

Question 3

Causes of neonatal jaundice?

Answer 3

Increased production or decreased excretion

Question 4

Increased production of bilirubin?

Answer 4

Haemolytic disease of the newborn
Haemorrhage
Cephalohematoma
Polycythaemia
Sepsis
G6PD

Question 5

Decreased clearance of bilirubin?

Answer 5

Prematurity
Breast milk jaundice
Neonatal cholestasis
Extrahepatic biliary atresia
Endocrine disorders
Gilbert syndrome

Question 6

Brain damage due to high levels of bilirubin?

Answer 6

Kernicterus

Question 7

Treatment of jaundice?

Answer 7

Treat underlying cause
Hydration
Phototherapy
Exchange transfusion if more severe

Question 8

How long is cyanosis normal for?

Answer 8

10 minutes should be pink

Question 9

Erythema toxicum?

Answer 9

Maculopapular rash

Cause unknown, usually clears in 1-2 weeks

Question 10

Naevus simplex?

Answer 10

Stork marks
Eyelid and back of neck
gradually fade

Question 11

Hypoglycemia in newborns?

Answer 11

Jitteriness
Unstable temp.
Lethargy 
Apnoea
Poor suck/feeding
Vomiting

Question 12

Commonest causes of neonatal sepsis?

Answer 12

About 80% of cases =
Group B Strep or E. coli

(Listeria, Coagulase negative staphylococci, haemophilus influenzae)

Question 13

Management of presumed sepsis?

Answer 13

IV penicillin and gentamicin

Kids hospital is amoxicillin and cefotaxime

Question 14

Symptoms of sepsis?

Answer 14

Pyrexia or hypothermia
Poor feeding
Lethargy or irritable
Early jaundice
Floppy
Asymptomatic

Question 15

Transient tachypnoea of the newborn?

Answer 15

Self limiting, first few hours

Delay in clearance of foetal lung fluids

Question 16

Blue baby?

Answer 16

Urgent treatment

Rule out sepsis and respiratory before cardiac causes

Question 17

Five common cardiac diagnoses for “blue baby”

Answer 17

1: Truncus arteriosus
2: Transposition of the great arteries
3: Tricuspid atresia
4: Tetralogy of Fallot
5: Total Anomalous Pulmonary Venous Drainage

Question 18

Hypothermia treatment approach?

Answer 18

If unable to maintain temp. admit to NICU in an incubator
Sepsis screen and antibiotics
Check thyroid function?
Monitor blood glucose

Question 19

Neonatal abstinence syndrome? (NAS)

Answer 19

Withdrawal from addictive substances exposed to in utero

Question 20

Treatment of NAS?

Answer 20

Comfort
Morphine
Phenonarbitone

Question 21

Monitoring of NAS?

Answer 21

Urine toxicology

Finnegan scores