Neonatology

Question 1

when does the CVS develop in embryology?

Answer 1

end of the 3rd week

Question 2

oxygenated blood via the umbilical vein (in utero) is carried by what?

Answer 2

ductus venosus

Question 3

what is the ductus arteriosus?

Answer 3

protects the lungs against circulatory overload

allows the right ventricle to strengthen

carries low oxygen saturated blood

Question 4

ductus venosus connects what 2 vessels?

Answer 4

umbilical vein

IVC

Question 5

ductus venosus carries what kind of blood

Answer 5

mostly oxygenated

Question 6

ductus venosus, ductus arteriosus, umbilical vein and umbilical arteries become what after birth?

Answer 6

ligaments

Question 7

physiological jaundice can lead to what serious complication?

Answer 7

Kernicterus

Question 8

what is Kerniterus?

Answer 8

toxic - deposits in the brain of fat soluble bilirubin

causes cerebral palsy, learning difficulties etc

Question 9

if a baby is small for dates - what are the possible causes?

Answer 9

small for gestational age (SGA)

intra-uterine growth restriction

pre-eclampsia

chromosomal (edwards syndrome)

foetal infection

twin pregnancy

Question 10

what are common problems a small for dates baby may present with?

Answer 10

perinatal hypoxia

hypoglycaemia

hypothermia

thrombocytopenia

Question 11

preterm respiratory problems

Answer 11

RDS (respiratory distress syndrome)

Question 12

how do you treat RDS

Answer 12

prevention (antenatal steroids)

surfactant

early intubation

Question 13

broncho-pulmonary dysplasia

Answer 13

is a form of chronic lung disease that affects newborns (mostly premature) and infants. It results from damage to the lungs caused by mechanical ventilation (respirator) and long-term use of oxygen

Question 14

brain issues in preterm babies

Answer 14

intra-ventricular haemorrhage

Question 15

Persistent ductus arteriosus

Answer 15

additional blood to the pulmonary circulation

you get systemic ischaemia

Question 16

necrotising entero-colitis

Answer 16

ischaemia and inflammatory changes

necrosis of the bowel

parenteral nutrition

Question 17

Jaundice is always abnormal (needs investigating) if it occurs when?

Answer 17

within 24 hours of birth

Question 18

Jaundice within 24 hours of being born is likely to be:

Answer 18

haemolytic (G2PD, Rh incompatibility)

TORCH (congenital infection)

Question 19

what does TORCH stand for in congenital infections?

Answer 19

toxoplasmosis

rubella

CMV

HSV

Question 20

2nd day to 3rd week jaundice causes:

Answer 20

breast milk jaundice

physiological jaundice (usually gone after a week)

sepsis

haemolytic disorders

Question 21

jaundice after 3rd week causes:

Answer 21

cholestasis

pyloric stenosis

biliary atresia

Question 22

phototherapy in jaundice does what?

Answer 22

makes bilirubin into a water soluble isomer

making it able to be excreted

Question 23

where do stork marks appear?

Answer 23

back of the neck

midline of the face

(they gradually fade)

Question 24

hypoglycaemia can occur when:

Answer 24

premature babies

perinatal stress

Question 25

what are the symptoms of hypoglycaemia in neonates?

Answer 25

jitteriness

temperature instability

lethargy

hypotonia

poor suck/feeding

vomiting

seizures

Question 26

how do you treat developmental dysplasia of the hip

Answer 26

relocate the femur to acetabulum so hip develops normally

Pavlik harness

Question 27

what are some defects associated with trisonomy 21:

Answer 27

dysmorphism (low set ears, single palmar creases)

hypotonia

cardiac defects

learning problems

thyroid problems

Question 28

how do you treat a baby with sepsis?

Answer 28

IV penicillin and gentamicin (1st line)

Vancomycin (2nd line)

Question 29

neonatal sepsis bacteria:

Answer 29

group B strep

E.coli

listeria

haemophilus influenzae

Question 30

complications of sepsis in a neonate

Answer 30

hepatomegaly/jaundice/hepatitis

cataracts/ retinitis

microcephalous

deafness

hydrocephalus

splenomegaly

Question 31

what is TTN?

Answer 31

transient tachypnoea of the newborn

Question 32

what are the cases of respiratory distress in the newborn?

Answer 32

respiratory distress syndrome (surfactant deficiency)

transient tachypnoea of the newborn

meconium aspiration

sepsis

Question 33

how do you investigate the ‘blue baby’?

Answer 33

exam and history

sepsis screen

blood gases and glucose

CXR

ECG

echo

Question 34

differentials for cyanosis in babies

Answer 34

tricuspid atresia

truncus arteriosus

pulmonary atresia